South Hadley, MA - Application for Appointment to Board, Commission or Committee

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Application for Appointment to Board, Commission or Committee

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	Committees: Before the Board of Selectmen makes appointments, they would like to know a little about you and why you feel you could contribute to the Board or Committee. Please take a few minutes and complete the brief expression of interest information below and click SEND to submit your application for consideration. Click here if you would prefer to print and mail a written copy to the Selectboard Office at 116 Main Street, South Hadley MA 01075. Please Note when submitting online, when you click the "Send" button you are agreeing to read a copy of the Massachusetts General Laws Chapter 268A "Conflict of Interest" provided by the Town Clerk, if appointed, and to the best of your abilities agree to abide by the provisions of the statute. You may receive a phone call to confirm your interest in the appointment.

Choose from the following:

Checkboxes	Checkbox Description	Checkboxes	Checkbox Description
	Agricultural Commission		Appropriations Committee
	Board of Appeals		Bylaw Review Committee
	Cable TV Advisory Committee		Canal Park Committee
	Capital Planning Committee		Commissioner of Whiting Street Fund
	Community and Economic Development		Ct. River Channel Marking Committee
	Conservation Commission		Council on Aging
	Cultural Council		Forestry Committee
	Historical Commission		Historic District Study Committee
	Holyoke Dam Relicensing Intrevenor Status Comm.
	Master Plan Implementation Committee		Municipal Golf Commission
	Open Space Committee		Personnel Board
	Personnel Review Board		Recreation Commission
	Rise of the Falls Facilitation Group		Solid Waste Advisory Committee
	Sustainability and Energy Commission		TM Electronic Communication Advisory Comm.
	Traffic Sign Committee		Tree Committee
			Other

Please provide the following information:

Field Description	Field Data	Required Field
Name:		required
Email:		required
Street Address:
Mailing Address:


Primary Phone:		required
Alternate Phone:
Cell Phone:

Are you a registered voter in the Town of South Hadley

Field Data

Are you a Town Meeting Member?

Field Data

Is any of your immediate family employed by the Town of South Hadley? (MA General Law defines immediate family as "His or her spouse, and their parents, childres, brothers, and sisters")

Field Data

Do you now or have you previously served in Town government?

Field Data

If yes, please list the board(s), commission(s) or committee(s) on which you serve(d), and the dates of service for each.

List your board or committee choices here in the order of preference. If you selected "Other" above, please indicate which board or committee you wish to apply.

Please give any details regarding your interest in this appointment?

What skills and experience do you have? (Knowledge, other volunteer experience, employment experience, etc.)

Please list any additional information you think may be helpful in reviewing your applicaiton.

How did you learn of the vacancy you are applying for? (Check all that apply)

If you indicated Another Resident or Other above, please provide the resident's name or provide additional details.

Copy/Paste Letter of Interest (Optional)

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