2. 

3. COMMUNITY SERVICE FORM

   FOR APPOINTMENT TO BOARDS OR COMMITTEES 

   Office of The Township Clerk 

   641 Plainsboro Road, Plainsboro, NJ 08536

   Phone: 609-799-0909, ext. 2547 Fax: 609-799-9204

4. 
6. Full Name

   I, resident of Plainsboro Township, hereby apply to volunteer on the following municipal board/s, commission/s, or committee/s: 

   YOU MAY CHOOSE UP TO THREE

   Click here to read brief description of the agencies 

8. • The Cable Television Advisory Committee
   • Environmental Advisory Committee
   • Human Relations Council
   • Library Board of Trustees
9. • Planning Board 
   • Shade Tree Advisory Committee
   • Zoning Board of Adjustment
11. 1st Choice
12. 2nd Choice
13. 3rd Choice

15. NOTE: Citizens appointed to serve on the Library Board of Trustees, Planning Board and Zoning Board of Adjustment are subject to the regulations of the New Jersey Local Government Ethics Law which requires the filing of a State mandated Financial Disclosure Statement every year.

17. Personal Information - Not Subject to Public Disclosure

    Pursuant to P.L. 1963, c. 73 (C.47:1A-1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.)

19. Email Address
20. Primary Phone Number
22. Address, City, State and Zip Code
24. Educational Background
26. Relevant Work or Professional Experience
28. Involvement in Professional or Community Organizations
30. Previous Service on Any Board, Commission, or Position
    List dates and positions.
32. Describe briefly why you are seeking the appointment and what you have to offer.
34. Digital Signature
35. Date
    Date
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field