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2. Boards and Committees
4. Your Name
6. Your Address
8. Your Email Address
10. Your Phone Number
12. Political Affiliation
14. Qualifications
16. Years of Residence
18. Present Employer
20. Job Title
22. Age
24. Current Civic or Community Participation
26. Education
28. If appointed when could you meet? Morning. afternoon, evening
30. If any what Committees are you presently on?
32. Do you anticipate any conflicts of interest
34. Which Committees

    1. Agriculture Committee
    2. Affordable Housing Committee
    3. Arts Advisory Committee
    4. Board of Ethics
    5. Cemetery Advisory Board
    6. Commission On Aging
    7. Conservation Commission
    8. Design Review Panel
    9. Eastern Highland Health District Board of Directors
    10. Eastern Regional Tourism District
    11. Economic Development Commission
    12. Emergency Management Advisory Council
    13. Historic District Commission
    14. Housing Authority Board of Directors
    15. Housing Code Board of Appeals
    16. Human Rights Commission
    17. Human Services Advisory Committee
    18. Library Advisory Board
    19. Mansfield Advocates for Children
    20. Mansfield Downtown Partnership Board of Directors
    21. Parking Steering Committee
    22. Parks and Natural Resources Committee
    23. Recreation Advisory Committee
    24. School Building Committee
    25. Solid Waste Management/Recycling Committee
    26. Sustainability Committee
    27. Town/University Relations Committee
    28. Transportation Advisory Committee
    29. Water System Advisory Committee
    30. Windham Regional Transit District Board of Directors
    31. Youth Services Advisory Board
36. Other
    Please use box to fill in your committee name
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

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42. Submit

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