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Citizen Leadership Form

Citizen Leadership Form

I, [state name below], hereby apply to perform public service on the following municipal authorities, boards or commissions:

I also understand that citizens appointed to serve on Borough of Highlands Authorities, Boards, Commissions and/or Committees are subject to the regulations of the New Jersey Local Government Ethics law which may require the filing of a Financial Disclosure Statement.

Please note that any personal information entered is considered personal information, and is therefore deemed confidential for the purpose of P.L. 1963, c. 73 (C.47:1A-1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.).

Citizen Leadership Form

Name
First Choice
Second Choice
Third Choice
State
Applicant Experience Please list any: education, prior volunteer experience, work related experience; or other civic involvement which could be of use to the authorities, boards or commissions which you listed above:
Personal Information* Phone
Address
Email
Are you indebted or obligated, in any manner, to the Borough of Highlands except for current sewer or taxes? (If yes please contact the Borough Administrator 732-872-1224x203 KGonzales@highlandsborough.org)	Yes No
I understand I may have to file a Financial Disclosure Statement (as noted at the top of this form)	Yes No