Date:

Please list in order of preference those boards and committees in which you are interested.

1. *

2.

3.

Name: *

Address:   *

		Is your home phone unlisted? *
Telephone Numbers:	Home*	Yes	No
	Work
	Fax

E-mail Address: *

Occupation: Present Employer:

Why did you choose the boards(s) or committee(s) listed above? *

What talents/skills do you feel you would bring to this position?*

What municipal boards, volunteer organizations or community service groups have you worked with in the past and for what length of time?

Are you employed by the Town of Cape Elizabeth or Cape Elizabeth School Department?* Yes No

If so, please explain:

Do you serve as a volunteer for the Town of Cape Elizabeth or Cape Elizabeth School Department?* Yes No

If so, please explain:

Is your schedule flexible enough to allow you to attend meetings regularly?* Yes No

If you have a resume, please feel free to email it to Debra Lane, Assistant Town Manager, Town of Cape Elizabeth