APPLICATION TO SERVE ON BOARDS
AND COMMITTEES
TOWN OF BAR HARBOR
Last: _______________________________________ First: ____________________________ Initial: ____
Town Council respectfully requests that all information is thoroughly completed to provide adequate information
for full consideration, including when re-applying. Incomplete applications may impede consideration.
Physical Resident Address: ______________________________________________________________________________
Mailing Address: _______________________________________________________________________________________
Business Address: ______________________________________________________________________________________
Business Phone: _____________________________ Home Phone: ___________________________
E-mail Address: ___________________________________________________ FAX Number: ________________________
How long have you lived in Bar Harbor: _______ Months
_______ Years
Occupation:
______________________________________________________
Is this your first application or are you re-applying?
Indicate the Board(s) and/or Committee(s) you are interested in serving on.
Appeals Board:
Assessment Review Board:
Conservation Commission:
Cruise Ship Committee:
Communication &
Technologies Committee:
Education:
Previous Bar Harbor Boards or Committees on which you have served:
_______________________________________________________ Years Served: __________________________________
_______________________________________________________ Years Served: __________________________________
_______________________________________________________ Years Served: __________________________________
Page 1 of 2
Date 1/22/20
Design Review Board:
Hancock County Planning
Commission:
Harbor Committee:
Housing Authority:
Marine Resource Committee:
Parking Solutions Task Force:
Parks & Recreation:
Planning Board:
Age Friendly Committee:
Warrant Committee:
Task Force on Climate:
Clear Form
When was the last time you attended a meeting of the board for which you applied?
Have you read the enabling ordinance? Yes No
Will you commit to attend at least 75% of the meetings? Yes No
Will you commit to take the required Ethics Training? Yes No
NoWill you be available to attend the Council meeting in which your appointment will be discussed? Yes
Other relevant work or volunteer experience: (Please list the Organization, its Address, your Position and the Dates Served.)
Please provide a brief s
tatement indicating why you are interested in serving/or renewing your service on this committee.
STATEMENT OF QUALIFICATIONS:
Please provide a brief statement indicating why you feel you are qualified or what you would like to offer to be considered for
the appointment. Attach another sheet if you like.
Signature: ________________________________________________ Date: _____________________
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2
Date 06/10/2016