I, , 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.

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:

Address of Residence:

E-Mail Address:

IP Address: