Augusta, ME - Committee Membership Application

Committee Membership Application


	NOTE: Please fill out the following form, and the Webmaster will refer it to the appropriate department for further action. Be sure to fill out the form completely, or we will be unable to properly respond. All applications expire 24 months from submittal date, unless renewed by the applicant.

Choose from the following:

Please provide the following information:

Name:		required
Email:		required
Address:		required
City:		required
State:		required
Zip:		required
Phone Work:
Phone Home:
Phone Cell:
Fax:

Reason for seeking Appointment.

Education, Training or Experience relevant to appointment sought and any prior service on community boards.

Special skills, knowledge, talents, insights, or point of view that you might offer to the Board or Committee and any objectives you may have for the position.

The City of Augusta, ME does not discriminate on the basis of age, race, sex, religion, creed, national origin, color, physical or mental handicap. The Board of Selectmen, or the appropriate appointing body, will seek to make balanced and representative appointments to all citizen boards and committee.