Form
Town Board Chair Appointment Interest and Application Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Occupation/Title
Background experience and education that may be related to your service:
Reasons you are interested in serving the Town of Verona through an appointment:
Other organizations, committees or community activities you have been involved with:
Are you currently or have you previously served on a Town Verona Board, committee or commission?
*
Yes
No
If yes, which?
Resident of the Town of Verona since?
*
Which committees or commissions are you interested in serving on?
*
Plan Commission
Public Works Committee
Ordinance Committee
Financial Sustainability Committee
Natural and Recreational Areas Committee (NRAC)
Please verify that you are human
*
Submit
Should be Empty: