Form Center

2. First Name*
3. Last Name*
5. Residence Address*
7. City
8. State
9. Zip Code
11. Mailing Address, if different
13. City
14. State
15. Zip Code
17. Phone (Home):
18. (Work):
19. (Cell):
21. Email Address*
23. Employer:
25. Employer Address:
27. Occupation/Title:
29. 1.) Which Board/Commission are you applying for?*

    1. Board of Canvassers
    2. Budget Board
    3. Conservation Commission
    4. Juvenile Hearing Board
    5. Library Board of Trustees
    6. Lincoln Housing Authority
    7. Parks & Recreation Commission

    1. Personnel Board
    2. Planning Board
    3. Tax Assessor Board of Review
    4. Tenant Board
    5. Zoning Board of Review
    6. Capital Improvement Revolving Fund Committee
    7. Other
31. 2.) If applicable, are you seeking a

    1. Full Member position
    2. Alternate position
33. 3.) Town Charter provisions require that all regular and alternate members of Boards/Commissions shall be qualified electors of the Town of Lincoln. Are you a registered voter in the Town of Lincoln?

    1. Yes
    2. No
35. 4.) How did you hear about this Board/Commission?
37. 5.) Why are you seeking an appointment with this Board/Commission?
39. 6.) What is your experience or knowledge regarding the duties of this Board/Commission?
41. 7.) Please list any education, experience, professional achievement, previous occupation, skills, or special interests you may have that will assist you with this Board/Commission:
43. 8.) Would there be a possible conflict of interest if you were appointed to this Board/Commission?

    1. Yes
    2. No
45. If yes, please explain:
47. 9.) Please list all other Boards/Commissions on which you have previously served in this or other Towns:
49. 10.) Optional: If you have a resume, references or any other documentation that would assist in the selection process, please attach a copy to this application.
51. Submission of this form in no way assures an appointment. All Board/Commission vacancies shall be filed by town residence that are deemed qualified to serve in a particular capacity.
53. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
55. Electronic Signature
57. Date:
    Date:
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field