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2. Instructions for Completing this Form
   • This Application of Intent to Serve on a Board or Committee replaces a Letter of Intent submission; only the application is required to express interest in volunteering to serve.
   • Please include qualifications they would bring to the position. 
   • Resumes or any other supporting documents may be attached to the form but are not required.  They will be forwarded to the Selectmen's office or to the appropriate appointing authority with a copy to the Town Clerk.
6. Name*
7. Date*
   Date
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Email Address*
18. What Board/Committee are you applying for?*
    -- Select One --Board of Library TrusteesBoard of RegistrarsCable CommissionConservation CommissionCouncil on AgingCultural CouncilDisability CommissionEconomic Development CommitteeHistorical CommissionMemorial Day CommitteeWater and Sewer CommissionZoning Board of AppealsOther - Not Listed
20. Are you a new applicant or are you an incumbent seeking reappointment?*
    -- Select One --New ApplicantIncumbent
21. Have you attended a meeting of this particular Board/Committee?*
    -- Select One --YesNo
23. Have you served on any other town boards/committees before? *
    -- Select One --YesNo
24. If yes, please list previous boards:
26. Why are you seeking an appointment?*
28. Please list any education, experience, knowledge, or special interests you may have that will assist you with this Board/Committee.*
30. 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.
32. Electronic Signature
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field