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2. 
4. Date:
   Date:
6. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OneBoard of Assessment Review (BAR)Board of EthicsBoughton Park CommissionCemetery Preservation & Restoration CommitteeConservation BoardHistoric Advisory CommitteeParks & Recreation Citizens Advisory CommitteeTown Planning BoardTown Zoning Board of Appeals
8. Personal Information
10. First Name*
11. Last Name*
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 Victor*
35. Education
37. High School
39. College
41. Trade or Business School
43. Organization Membership Information
45. Are you currently serving on other Boards, Commissions, or Committees?*

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

    1. Yes
    2. No
51. If yes, which
53. Please list organization memberships and positions held
55. Please List Areas of Special Interest
57. Please attach a Resume & Cover Letter
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit Submit and Print

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