TOWN COMMITTEE CANDIDATE INFORMATION SHEET
A. NAME: ____________________________________
DATE: ___________________
STREET ADDRESS:
___________________________________________________________
MAILING ADDRESS (if different):
_______________________________________________
B. LIST COMMITTEE (S) IN, WHICH YOU ARE
INTERESTED: _____________________
________________________________________________________________________
________________________________________________________________________
C. PLEASE DESCRIBE CURRENT EMPLOYMENT AND PAST
EMPLOYMENT WHICH MAY BE RELEVANT TO THE ROLE OF THE COMMITTEE OR
BOARD:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
D. PLEASE TELL US OF ANY PRIOR EXPERIENCE OR
COMMUNITY SERVICE WHICH WOULD BE HELPFUL:
________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
E. PLEASE EXPLAIN WHY YOU WISH TO SERVE:
_______________________________
________________________________________________________________________
________________________________________________________________________
F. DO YOU KNOW OF ANY REASON YOU WOULD HAVE A
PROBLEM WITH THE TIME REQUIREMENTS OF SERVING OR A POSSIBLE CONFLICT
OF INTEREST IN SERVING:
___________________________________________________________________
________________________________________________________________________________________________________________________________________________
G. DO YOU HAVE ANY IMMEDIATE RELATIVES CURRENTLY
SERVING ON ANY TOWN COMMITTEES OR BOARDS? IF SO, PLEASE EXPLAIN:
___________________
________________________________________________________________________
________________________________________________________________________
H. PLEASE TELL US WHAT, IF ANY, ORGANIZATION(S)
YOU ARE CURRENTLY A MEMBER OF:
________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I. IF ANY OF THE ABOVE QUESTIONS REQUIRE MORE
SPACE TO ANSWER OR IF THERE IS ANY ADDITIONAL INFORMATION YOU BELIEVE
WOULD BE HELPFUL TO THE MUNICIPAL OFFICIALS SEARCH COMMITTEE, PLEASE
DESCRIBE BELOW OR ON AN ADDITIONAL SHEET OF PAPER. THANK YOU IN
ADVANCE FOR YOUR INTEREST IN SERVING THE TOWN OF
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________