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Citizen Leadership Application

  1. Certification

    I hereby apply to perform public service on the following municipal authorities, agencies, boards, committees and/or commissions.

  2. Please select which of the following you would be interested in serving on. Check All That Apply.

  3. Please list any education, prior volunteer experience, work related experience, or other civic involvement which could be of use to authorities, boards or commissions which you selected above.

  4. Please note that participation or involvement on a Public Authority, Board, Commission or Committee may require member to file a Financial Disclosure Statement with the State of New Jersey annually. Failure to submit a required Financial Disclosure Statement may result in fines.

  5. Correspondence, documents created, received, or distributed due to involvement on a Board, Commission or Committee is subject to OPRA (Open Public Records Act) Requests. 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)

  6. Leave This Blank:

  7. This field is not part of the form submission.