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2. To the Town Manager:

   I hereby request to be considered for membership to the following board(s) and/or committee(s):  (If more than one, please indicate your preference in the last box on this form, in the desired order.)

4. Choose from these boards and committees:

   1. Recreation Commission
   2. Zoning Board of Appeals
   3. Toy Town Partnership
   4. Communications Commission
   5. Cultural Council
   6. Winchendon Community Park Programming Committee
   7. Winchendon Community Park Infrastructure Committee
   8. Master Plan Implementation Committee
6. Please provide your information:
8. Full Name*
10. Email*
12. Residential Address*
14. Residential Phone*
16. Business Address
18. Business Phone
20. Mailing Address (if different)
22. Are you registered to vote in Winchendon?

    1. Yes
    2. No
24. Please list Membership in community organizations, dates involved, and activities performed:
26. Do you have any skills, experience, or training you would like to mention?
28. What is your reason for wanting to serve on this board or committee?
30. List the top 3 choices of boards or committees that you would like to serve on (1, 2, 3, in desired order).
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field