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Board Application Form

2. Please Note:
   
   All appointees must abide by the City’s Code of Ethics . You must be a Norwich resident who is registered to vote. You must not be delinquent on your taxes.
   
   The Mayor's Office and the City Manager's Office will receive all applications for Boards, Commissions, or Committees appointed by the City Council or the City Manager.
   
   Reappointments to any Board, Commission, or Committee will be interviewed by the City Council Sub-Committee for Appointments and Reappointments or the City Manager for consideration.
   
   Applicants are encouraged to submit a personal statement and a resume along with their signed application.
4. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OneBoard of Assessment AppealsBaseball Stadium AuthorityBuilding Code Board of AppealsCable Television Advisory Council Census Complete Count Committee (2020)Commission on the City PlanCommunity Development Advisory CommitteeConnecticut Municipal Electric Energy Cooperative (CMEEC)Dangerous Buildings, Board of ReviewDesign Review BoardDowntown Coordinating CommitteeEastern CT Regional Tourism DistrictEthics CommissionGolf Course AuthorityGreeneville NRZ CommitteeHarbor Management CommissionHistoric District CommissionHousing AuthorityIce Arena AuthorityInland Wetlands, Water Courses, & Conservation CommissionMohegan Park Improvement & Development Advisory CommitteePlan of Conservation & Development CommitteePersonnel & Pension BoardPersons with Disablilities, Commission for thePublic Appearance and Beautification CommitteePublic Parking CommissionPublic Safety CommitteePublic Utilities Commission (Sewer Authority)Recreation Advisory BoardRedevelopment AgencyRehabilitation Review CommitteeSachem Fund BoardSenior Affairs CommissionThames Valley Council for Community Action Uncas Health District Volunteer Firefighter Relief Fund Committee Youth Service Advisory Board Zoning Board of Appeals
6. Personal Information
8. First Name*
9. Last Name*
11. Sex:*

    1. Male
    2. Female
13. Address1*
15. Address2
17. City*
18. State*
19. Zip*
21. Home Phone Number*
23. Business Address*
25. Business Phone Number*
27. Occupation*
29. Email Address*
31. Residency Information
33. Length of Residency in Norwich*
35. Are you a resident elector of Norwich*

    1. Yes
    2. No
37. Education and Hobbies
39. High School
41. College
43. Trade or Business School
45. Hobbies
47. Organization Membership Information
49. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
50. If yes, which
52. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
53. If yes, which
55. Please list organization memberships and positions held
57. Please List Areas of Special Interest
59. Please Enter Basic Resume Information Below or Upload your Resume
60. Resume Upload
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

* indicates a required field