I would be interested in serving on the following:

• Board of Auditors
• Agricultural Security Area Advisory Committee
• Lower Salford Authority
• Park Board
• Planning Commission
• Zoning Hearing Board
• Recreation Authority
• UCC Appeals Board
• Industrial Development Authority
• Communications Committee
• Open Space/Trails Committee

My present occupation is:

Special qualifications that may be of help to the municipality:

I have served on:

In the community of:

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Include any additional files that you think would support your application, like a resume for example.

Please note: This form will remain on file until notice from you or for a period of 2 years

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