Please indicate which boards or committees you are interested in: * General Recreation Board Planning Commission Zoning Hearing Board Other General: Other: Please provide the following information: Name: * Email: * Address: City: State: Zip Code: Home Phone: Work Phone: Cell Phone: Number of Years a Resident of Lower Towamensing: Why do you wish to serve? What do you hope to accomplish if you are appointed to serve? What specific skills/experiences do you believe will contribute to this Board/Committee? Have you served on a Board or Committee in Lower Towamensing or anywhere else? If so, state the name of the Board/Committee along with the dates of service. References: (Include Contact Information) List any references who currently serve on this Board/Committee: List references who reside in Lower Towamensing: List any additional references: Leave this field blank
