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Board and Committee Application Form

2. 

3. Town of New Castle
   200 South Greeley Avenue, Chappaqua, NY 10514

   200 South Greeley Avenue, Chappaqua, NY 10514

5. Town of New Castle
   Experience Summary for Volunteer Boards & Commissions Appointments

   Experience Summary for Volunteer Boards & Commissions Appointments

7. Select the Board, Commission, or Committee applying for*
   -- Select One --Advisory Committee on Cable TVArts and Culture CommitteeArchitectural Review BoardBoard of Assessment ReviewBeautification BoardBusiness Development Advisory CommitteeClimate Smart Communities Task ForceConservation BoardDiscover Chappaqua CommitteeInclusion and Diversity CommitteeCommunity Preparedness CommitteeEnvironmental Review BoardEthics BoardEvery Person is Connected (EPIC)Health & Wellness Task ForceHolocaust and Human Rights CommitteeLandmark Advisory CommitteeMandate Relief CommitteeMillwood-West End Advisory BoardNew Castle Airport Advisory BoardPlanning BoardRecreation and Parks CommissionSept 11th Memorial CommitteeSustainability Advisory BoardYouth Civic Actions CommitteeZoning Board of Appeals

9. Personal Information

11. First Name*

12. Last Name*

14. Sex:*

    1. Male
    2. Female

16. Address1*

18. Address2

20. City*

21. State*

22. Zip*

24. Email Address*

25. Home Phone Number*

26. Cell Phone Number

28. Business Address

30. Business Phone Number

32. Occupation*

34. Residency Information

36. Years of Residency in New Castle*

38. Are you a registered voter*

    1. Yes
    2. No

40. Education and Experience

42. High School

44. College

46. Trade or Business School

48. Work Experience*

50. Organization Membership Information

52. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No

54. If yes, which

56. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No

58. If yes, which

60. Instructions
    You may submit this form online, or print and send it to: Supervisor, Town of New Castle 200 South Greeley Avenue Chappaqua, NY 10514

    You may submit this form online, or print and send it to: Supervisor, Town of New Castle 200 South Greeley Avenue Chappaqua, NY 10514

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

    This field is not part of the form submission.

64. Submit Submit and Print

* indicates a required field