MAPL Board Application

The information that you provide on this form will assist your local municipality in understanding your interest and strengths for serving the Library and the community we serve.
1. Personal Information
Name
Home Address
Day Telephone
Evening Telephone
Email Address
example@example.com
How long have you lived at this address?
Name of Employer
Address of Employer
2. Municipality
I reside in:

Adams TownshipMars BoroughMiddlesex TownshipValencia Borough
General Information
Have you previously served on the Mars Area Public Library board?

YesNo
If yes, when?
Have you ever served in an appointed capacity or board of directors for another organization?

YesNo
If yes, what was the name of the organization and your role?
What special experiences or qualifications/skills do you have that you would apply to serving on the MAPL Board of Trustees?
In the space below please provide any additional information that you wish, including a brief statement of why you are interested in serving on the MAPL Board of Trustees
By submitting this form, I understand that if I am appointed to the Mars Area Public Library Board of Trustees that I would be responsible for adhering to any policies, rules, laws or guidelines established for the appointed position.
Signature

Clear
Date

MonthDayYear
Date
Thank you very much for taking the time to complete this Expression of Interest in serving your community on the MAPL Board of Trustees. The Library and your residing municipality office will retain this Expression of Interest form for two (2) years from the date of submittal.

If you have any questions or comments, please contact the Library Director at (724) 625-9048 ext 205.
Should be Empty:

1. Personal Information

2. Municipality

General Information