Boards and Commissions Application

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Select Board or Commission

Applicant Name

Occupation

Applicant Email

Applicant Phone (daytime or cell)

Applicant Physical Address

Physical Address Line 2

City

State

ZIP/Postal Code

Communities to Represent

Additional Communities?

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Qualifications

Why are you interested in this board or commission?

Other Items to Consider

Other Boards, Commissions, or Committees

Financial, Budget, or Management Background

Media Source

Other Media (if selected)

Resume

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