2. Application for Boards, Commissions and Committees of the Town of Madison

   Thank you for applying to serve on a Madison board, commission or committee.

   The Democratic and Republican Town Committees assist the town in recruiting and interviewing applicants for these positions. You do not need to register as a Democrat or Republican to be considered. An unaffiliated voter may apply to the committee of his or her choice. The goal is to seat the most qualified candidates regardless of party affiliation.

   Please complete the following questionnaire. It will serve as a basis for your interview and help interviewers conduct a substantive but relatively brief interview.

   After receiving your application, the nominations committee to which you applied will interview you to consider making a recommendation to its full town committee regarding your appointment. If the town committee votes in favor, your application will be forwarded to the Board of Selectmen. If the Selectmen vote to seat you, you will be notified of your appointment by the First Selectmen. You will be sworn in by the Town Clerk before taking up your position.

4. As you complete the questionnaire, please keep the following in mind:
   1. We seek volunteers who will bring skills, experience, integrity, insight, and objectivity to issues before boards and commissions. Please give answers that reflect your perspective and experience.
   2. Candidates for “alternate” positions have the same responsibilities as full members and should be prepared to make a significant commitment of time and attendance.
6. Board or commission for which you are applying:
8. First Name
9. Last Name
11. Address
13. City
14. State
15. Zip Code
17. Phone Number
18. Email Address
20. Length of Madison Residency:
21. Party Registration

    1. Democrat
    2. Republican
    3. Unaffiliated
    4. Other
23. 1) Your educational background including special courses or studies that may contribute to your effectiveness in this position:
25. 2) Occupational background and names of employers:
27. 3) Past and present community service and political service:
29. 4) What is your understanding of the function of this board or commission?
31. 5) What do you hope to accomplish by serving on this board or commission?
33. 6) In addition to meetings, effective participation may require time for preparation follow-up, site visits, or other efforts. Do you have time available to serve effectively? Would job-related travel, seasonal residency, or other factors affect your availability?
35. 7) Is there anything in your present situation or in your past that might constitute a conflict of interest in your service or in evaluating proposals before this board or commission? If so, please describe:
37. 8) Have you ever served on a board or commission in Madison or another town? If so, indicate where and when and describe the most interesting and the hardest parts of the position:
39. 9) Do you own or are you employed by an enterprise that does business with the Town? If so, what is the nature of the business?
41. Today's Date
    Today's Date
42. Thank you for your time and willingness to serve the Town of Madison!
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44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

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