Board and Committee Appointment Application Form

2. First Name*
3. Last Name*
5. Board/Committee/Commission Vacancy*

   Please specify which vacancy or vacancies you are applying for.

7. Email Address*
8. Best Contact Phone Number*
10. Address 1*
12. Address 2
14. Town*
15. State*
16. Zip Code*
18. Resume Upload*
19. Cover Letter Upload*
21. 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.
23. Electronic Signature
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit Submit and Print

* indicates a required field