Advisory Committee, Board, or Commission Application

I request appointment to (choose one):

Town Council

Housing Authority

Planning and Zoning Commission

Cemetery Committee

First Name

Last Name

Email Address

Phone Number

Residence Address (Street, City, State, Zip Code)

Mailing Address (Street, City, State, Zip Code)

How long have you lived in Johnstown?

Current Occupation & Employer

Please list your volunteer and/or work experience:

Are you presently serving on Town Council or on an appointed committee, board or commission? If so, which one(s)?

Why do you wish to be appointed?

List any abilities, skills, or interests which are applicable to the position for which you are applying:

Are you committed to attending meetings, which generally happen in the evenings, 2-3 times a month?

Yes

Are you committed to serving an entire term?

Yes

Please specify any activities which might create a serious conflict of interest if you should be appointed to a particular board, commission or committee.

Although you are not required to have extensive knowledge or experience related to the board, commission or committee, please list any licenses, certificates or other specialized training applicable to the board, commission or committee for which you are applying.

Please add any additional information or references you believe may be helpful in considering your application.

If you are not appointed at this time, are you interested in serving in the future?

Yes

May we contact you in the future if a vacancy opens?

Yes

What interests you most (or least) about the position?

What do you like most (or least) about the Town of Johnstown?

What would you like to see the Town accomplish in the next two (2) years?

What is your philosophy on growth?

What changes would you like to see occur in the Town of Johnstown?

Why should you be appointed?

Signature

By typing your name here you are acknowledging that everything on this form is true and accurate. This constitutes an electronic signature.