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2. Citizen Leadership Form - Hazlet Township

   P.L. 2009 Chapter 141
   Citizens may use this form to apply for consideration to serve on a municipal authority, board, commission or committee.

   Upon submission, the form will be sent to Mary Lynch, Municipal Clerk. You may contact the office by calling 732-217-8686 or email MLynch@HazletNJ.org. 

   Please be advised that appointees to boards, commissions and committees are subject to the regulations of the New Jersey Local Government Ethics Law, which may require the annual filing of a financial disclosure statement. 

4. Municipal Entities

   I hereby apply to be considered to perform public service on the following municipal entity. (See descriptions on the Boards & Committees page. )

   1. Environmental Commission
   2. Hazlet Alliance Board
   3. Land Use Board

   1. Open Space Advisory Council
   2. Recreation Advisory Committee
6. First Choice
8. Second Choice
10. Third Choice
12. Name*
14. City, State
16. Experience

    Please list any education, prior volunteer experience, work-related experience or other civic involvement which could be of use to authorities, board or commissions.

18. Upload Resume (Optional)
22. --- Personal Information Not Subject to Public Disclosure ---

    *The information in this section is considered personal information, and is therefore deemed confidential for the purpose of P.L. 1963, c. 73 (C.47:1A 1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.). All provisions of N.J.S.A. 40A:922.1 et. seq will apply (Local Government Ethics Law

24. Address of Residence
26. Phone Number
28. Email Address*
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field