Town of Bow

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 making application to volunteer for one or more of the following, in order of preference (1-first choice, 2-second choice, etc.):

_____ Planning Board _____ Zoning Board of Adjustment
_____ Regional Planning Commission _____ Parks & Recreation Commission
_____ Conservation Commission _____ Highway Safety Committee
_____ Historical Commission _____ Capital Improvement Committee
_____ Business Development Commission _____ Building Code Board of Appeals
_____ Town Center Study Committee _____ Merrimack River Advisory Committee
_____ Ambulance Oversight Committee

_____ Recycling/Solid Waste Committee
_____ Elections Assistance _____ Special Projects
_____ Other: ____________________  

2. For my appointment, please consider the following:

a. Occupation: ____________________________________________________________________
b. Employer:_______________________________________________ Since: _________________
c. 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
d. Education: _____________________________________________________________________
e. Relevant Experience: ____________________________________________________________
________________________________________________________________________________
f. Volunteer Time Available per week: ___________________
g. Previously appointed to any Town or School District Boards or Committees: ___ yes ___ no
h. If yes, list all Town/Positions: _____________________________________________________
i. Are you willing to serve as an alternate? ___ yes ___ no
j. 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.