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Citizen Leadership Form

I, Required , resident of Egg Harbor Township, hereby apply to perform public service on the following municipal authorities, boards or commissions:

Board of Assessment*

Economic Development Commission

Emergency Management

Environmental Commission

Great Egg Harbor National Scenic

Municipal Utilities Authority

Veterans Advisory Board*

Municipal Alliance

Pinelands Municipal Council

Planning Board

Recreation Commission

Rent Review Board

Zoning Board of Adjustment

Members of the above municipal authorities, boards or commissions are subject to complete a Financial Disclosure form annually.

*These boards are exempt from filing a Financial Disclosure form.

Please attach a list of any education, prior volunteer experience, work-related experience, or other civic involvement which could be of use to the municipal authorities, boards or commissions which you listed above.
Required

Personal Information Not Subject to Public Disclosure—the information in this section is considered personal information. Therefore, it is deemed confidential for the purpose of
P.L. 1963, c. 73 (C.47:1A-1 et seq) and P.L. 2001, c.404 (C.47:1A-5 et al).

Primary Phone Number:	RequiredInvalid format.
Address of Residence:	Required
E-Mail Address:	RequiredInvalid format.
IP Address:	38.107.179.220

This page last updated on February 16, 2012