Canton, Massachusetts · Saved source text
application
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Source page 1
Print Form Submit by Email
For office use only
Appointed: Yes No Date:
Date Resigned: or did not seek re-appointment:
Residency confirmation by Town Clerk:
Town of Canton
801 Washington St
Canton, MA 02021
781-821-5000 Fax: 781-821-2935
Application for
Board/Committee
Please submit this application to the Selectmen's Office.
Name: Date:
Residence: Email:
P.O. Box Phone (H):
Business: Phone (W):
Business Address: Occupation / Title:
Education:
1. What Board/Committee are you applying for?
1a. If applicable, are you seeking a : Full Member position Alternate/Associate position .
2. If you are not appointed to this Board/Committee, please list in order of preference, what other
Board/Committees you are willing to be considered for:
3. How long have you lived in Canton?
4. Are you a registered voter? Yes No
5. Have you been asked by a Board/Committee to become a member? Yes No
6. How did you hear about the Board/Committee?
7. Why are you seeking an appointment?Source page 2
8. What is your experience or knowledge regarding the duties of this Board/Committee?
9. Please list any education, experience, professional achievement, previous occupation, skills, or
special interests you may have that will assist you with this Board/Committee.
10. How many times during the last year have you attended a meeting of the Board/Committee to which
you would like to be appointed?
11. Would there be a possible conflict of interest if you were appointed to this Board/Committee?
Yes No If yes, please explain:
12. Have you ever had business before the Board/Committee to which you are requesting an apt.?
Yes No
If yes, please explain:
13. Please list all other Board/Committee's on which you have served in this or other towns.
14. What Precinct do you live in? One Two Three Four Five Six
Applicant's signature:
The filling out of this form in no way assures appointment. All board/committee vacancies
will be filled by citizens deemed most qualified to serve in a particular capacity.
Please return this form to the Selectmen's Office.