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Board Application Form

2. Please Note: <br><br> All appointees must abide by the City’s <a class="Hyperlink" title="Code of Ethics" target="_blank" href=" http://library.municode.com/HTML/11363/level3/PTIITHCOOR_CH2AD_ARTIVCOET.html#fn_13#TOPTITLE">Code of Ethics</a> . You must be a Norwich resident who is registered to vote. You must not be <a class="Hyperlink" title="delinquent on your taxes" target="_blank" href="http://library.municode.com/HTML/11363/level3/PTIITHCOOR_CH2AD_ARTIINGE.html#PTIITHCOOR_CH2AD_ARTIINGE_S2-20REBOCOAGETFAPATADUCI">delinquent on your taxes</a>. <br><br> 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. <br><br> 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. <br><br> Applicants are encouraged to submit a personal statement and a resume along with their signed application.

   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