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Town of Bow
Municipal Office Building
10 Grandview Road
Bow, NH 03304

Board/Commission/Committee – Appointment Application
(Appointments are made after the Annual Town Meeting as vacancies occur)

 

Name (last): ______________________________ Name (first): ____________________________

Phone (day): _________________________ Phone (evening): _________________________

Address: _______________________________________________ Lived in Bow since: _________

1. I am interested in volunteering for one or more of the following, in order of preference (1-first choice, 2-second choice, etc.):

_____ Ambulance Oversight Committee _____ Highway Safety Committee
_____ Business Development Commission _____ Planning Board
_____ Capital Improvement Committee _____ Public Safety Bldg/Town Center
_____ Cental NH Planning Commission _____ Recycling Committee
_____ Cental NH Planning Commission (TAC) _____ Street Renaming/Renumbering
_____ Conservation Commission _____ Town Governance Committee
_____ Drinking Water Protection Committee _____ Zoning Board of Adjustment
_____ Energy Committee _____ Upper Merrimack River Local Advisory Committee
_____ Heritage Commission

For my appointment, please consider the following:

  1. Occupation: ______________________________________________________________

  2. Employer:______________________________________________ Since: ____________

  3. Do you feel there could be any conflicts of interest with your personal beliefs, occupation, or employer by being appointed to server on this commission or committee: ___ yes ___ no

  4. Education: _______________________________________________________________

  5. Relevant Experience: ______________________________________________________

  6. ________________________________________________________________________

  7. Volunteer Time Available per week: ___________________

  8. Previously appointed to any Town or School District Boards or Committees: ___ yes ___ no

  9. If yes, list all Town/Positions: _______________________________________________

  10. Are you willing to serve as an alternate? ___ yes ___ no

  11. Are you willing to serve on a sub-committee? ___ yes ___ no

3. I would like to change and/or improve the following: _________________________________

_______________________________________________________________________________

4. The greatest personal attribute or qualification I can bring to this appointment is:

________________________________________________________________________________

5. I would like this appointment because: _____________________________________________

________________________________________________________________________________

 

Signature: ______________________________________________ Date: ________________

Please submit this form to: Town Manager, 10 Grandview Road, Bow, NH 03304-3403.

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