Form Center

2. First Name*
3. Last Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
13. Email Address*
15. Committee applying for*
    -- Select One --Economic Development CommitteePublic Arts CommitteePlanning Commission Water/Waste Water Committee
17. What interests you about serving on this committee?*
19. Why should the Town Board consider you for appointment/reappointment to this committee?*
21. What relevant experience, skills, and/or talents do you feel would help you be a contributing member to this committee?*
23. What additional skills, knowledge, and/or experience would you feel could help you be a better committee member? *
25. What do/would you enjoy most about serving on this committee?*
27. What do/would you enjoy least about serving on this committee?*
29. What is the purpose of the committee?*
31. What are the goals of the committee?*
33. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
35. Electronic Signature
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field