Town of Gray Board & Committee Application
Please answer all questions.
1. Date:
-
-
MM-DD-YYY
2. Name of Applicant:
First Name
MI
Last Name
3. Address:
Address Line 1
Address Line 2
City
State
Zip
4. Phone Number:
(
)
-
5. Email Address:
6. Occupation
7. Present Employer:
8. Employer Phone Number
(
)
-
9. Are You a Gray Resident?
Yes
No
10. Please select the Board or Committee in which you are most interested.
Zoning Board of Appeals
Library Board of Trustees
Grange No. 41 Scholarship Fund COmmittee
Dry Hydrants Committee
Dry Mills Schoolhouse Committee
Community Economic Development Committee
Planning Board
Charles Barker Scholarship Committee
Board Of Assessment Review
Public Safety Committee
Recreation & Conservation Committee
Solid Waste & Recycling Committee
Street Reconstruction Committee - Ad Hoc
Town Office Committee
11. Please select your second choice for the Board or Committee in which you are most interested.
Dry Mills Schoolhouse Committee
Community Economic Development Committee
Charles Barker Scholarship Committee
Planning Board
Board Of Assessment Review
Public Safety Committee
Recreation & Conservation Committee
Solid Waste & Recycling Committee
Dry Hydrants Committee
Grange No. 41 Scholarship Fund COmmittee
Library Board of Trustees
Zoning Board of Appeals
Street Reconstruction Committee - Ad Hoc
Town Office Committee
12. Please select your third choice for the Board or Committee in which you are most interested.
Dry Mills Schoolhouse Committee
Community Economic Development Committee
Charles Barker Scholarship Committee
Planning Board
Board Of Assessment Review
Public Safety Committee
Recreation & Conservation Committee
Solid Waste & Recycling Committee
Dry Hydrants Committee
Grange No. 41 Scholarship Fund COmmittee
Library Board of Trustees
Zoning Board of Appeals
Street Reconstruction Committee - Ad Hoc
Town Office Committee
13. Would you like to serve as a Regular Position or Alternate Position?
Regular
Alternate
14. Reason for choosing the Board and/or Committee?
15. What kind of contribution and benefit can you bring to the Town of Gray?
16. What talents and skills would you bring to this position?
17. What do you feel is the responsibility of the Board and/or Committee have you chosen?
18. What Municipal Boards, Volunteer Organizations or Community Service Groups/Committees have you worked on in the past, and for what length of time?
19. Will your schedule be flexible enough to allow you to attend meetings on a regular basis?
Yes
No
20. Are you familiar with the "Comprehensive Plan", as adopted by the Town of Gray?
Yes
No
21. Please feel free to comment on any consideration or aspect of your interest to a Board or Committee that will directly benefit the over-all advancement of the Town of Gray.
SurveyMagik 4.1
