City Of Bangor

Volunteer Committee Application Form

(Note: As an applicant, this information will be available to the press and public)

 

Please type or print clearly:

 

Name: __________________________________________________________

 

Home Address: ___________________________________________________

 

Business Address: _________________________________________________

 

Phone Number(s):

Home __________________ Office _________________ Cell_______________

 

Email Address:  ___________________________________________________

 

Professional or Civic Activities (include other committees you have served on): ________________________________________________________________________________________________________________________________

 

Education:

________________________________________________________________

 

Present Employer Name:

 

_____________________________________________Phone______________

 

Your Job Title: ____________________________________________________

 

I am interested in serving on the following committee (indicate 1st ,  2nd & 3rd choice):

 

□ Board of Appeals                                     □ Mall Marsh Commission

□ Board of Assessment Review                □ Parks & Recreation Advisory

□ Board of Ethics                                        □ Planning Board

□ Cultural Commission                               □ Sophia Kirstein Scholarship Trustees

□ Firearms Discharge                                □ Tree Board

□ Harbor Committee                                   □ Urban Renewal Authority

□ Hersey Fund Trustees                             □ Water District Trustees

□ Historic Preservation Commission        □ Willing to Serve Anywhere Needed

□ Housing Authority                                    

 

___________________________________     __________________________

Applicant Signature                                                  Date

 

Return to:

City Clerk

73 Harlow Street

Bangor, ME  04401