I would be interested in serving on the following:

• Community Day Committee
• Environmental Advisory Council
• Historic Commission
• Parks & Land Preservation Board
• Planning Commission

My present occupation is:

Special qualifications that may be of help to the municipality:

I have served on:

In the community of:

Optional file attachments

Include any additional files that you think would support your application, like a resume for example.

Please note: This form will remain on file until notice from you or for a period of 2 years

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