TOWN
OF
TEL: 207-763-3555 FAX:
207-763-4545
Community Interest Form
Please fill out this form if you are interested in serving
your community as a member of a
Town Board/Committee/Commission or Trustee.
Name:
_________________________________________________________________
Address:
_______________________________________________________________
Home Phone: ___________ Work Phone: ____________Cell
Phone: ________________
Email:_________________________________ Date:
____________________________
I am interested in serving on the
following: (Circle your choice)
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Board of Appeals
Board of Assessment Review
Budget Committee
Capital Needs Committee
Comprehensive Plan Review Committee
Cemetery
Trustee Conservation Commission Harbor Committee Land Use Committee
Financial Advisory Committee Gateway 1 Town Response Panel Lakes & Ponds Committee
Megunticook
Dam Committee
Recreation
Other
___________________________________________________________________
I would like to serve as a Regular Member Alternate Member
In the following space, please tell us about yourself and
why you would like to serve and/or
Continue to serve on the above circled
board/committee/commission/trustee. If
you need more space, please use the back of this sheet. You may attach a resume.
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References:
Name:__________________________________ Phone: ________________________
Name:
_________________________________
Phone: ________________________