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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. Green Team Advisory Committee
   2. Hazlet Alliance Board
   3. Land Use Board
   4. Library Commission

   1. Open Space Advisory Council
   2. Recreation Advisory Committee
   3. 175th Anniversary 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*
Leave This Blank:


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

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