NOTE: PLEASE BE ADVISED THAT THIS FORM, OR ANY MATERIALS SUBMITTED HEREWITH, MAY
BECOME A PUBLIC RECORD SUBJECT TO DISCLOSURE UNDER THE NEW JERSEY “OPEN PUBLIC
RECORDS ACT” (N.J.S.A. 47:1A-1 ET SEQ.).
Citizen Leadership
Form
VOLUNTEER BOARD,
COMMISSION OR COMMITTEE
Name:
__________________________________________________________________
List in order of
preference, Committee/s to which you would like to be appointed:
1. ____________________________
2. ________________________________
3._____________________________
4. ________________________________
Please describe
briefly relevant background, and/or training:
________________________________________________________________________
________________________________________________________________________
Have you served
previously on Committees in Upper Township?
___________________
________________________________________________________________________
Date:
_______________________
Signature: __________________________________
Please Return to:
Wanda Gaglione, Upper Township Municipal Clerk
PO Box 205
Tuckahoe, NJ 08250-0205
Email:
clerk@uppertownship.com
Fax: (609) 628-1836
Phone: (609) 628-2011
|
Personal
Information Not Subject to Public Disclosure*
Primary Phone Number:
Address of Residence:
Email Address:
*
The information in this section is considered personal information,
and is therefore
deemed
confidential for the purpose of P.L. 1963, c. 73 (C.47:1A-1 et seq.)
and P.L.
2001, c.
404 (C.47:1A-5 et al.). |