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Board and Committee Application Form

2. 
3. Town of New Castle
   200 South Greeley Avenue, Chappaqua, NY 10514
5. Town of New Castle
   Experience Summary for Volunteer Boards & Commissions Appointments
7. Select the Board, Commission, or Committee applying for*
   -- Select One --Advisory Committee on Cable TVArchitectural Review BoardArts and Culture CommitteeBeautification BoardBoard of Assessment ReviewBusiness Development Advisory CommitteeClimate Smart Communities Task ForceCommittee on Race and Equity (CRE)Community Preparedness CommitteeConservation BoardDiscover Chappaqua CommitteeEthics BoardEvery Person is Connected (EPIC)Environmental Review BoardHealth & Wellness Task ForceHolocaust and Human Rights CommitteeLandmark Advisory CommitteeMandate Relief CommitteeMillwood-West End Advisory BoardNew Castle Airport Advisory BoardPlanning BoardRecreation and Parks CommissionSustainability 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
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 Submit and Print

* indicates a required field