I would be interested in serving on the following:

• Board of Elected Auditors
• Planning Commission
• Zoning Hearing Board
• Park and Recreation Commission
• Environmental Advisory Council
• Chalfont New Britain Joint Sewer Authority Board
• North Penn Water Authority Board
• Chalfont-New Britain Emergency Management Services

My present occupation is:

Special qualifications that may be of help to the municipality:

I have served on:

In the community of:

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Please note: This form will remain on file until notice from you or for a period of 2 years

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