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I <br /> TOWN OF MASHPEE <br /> Town Hall, 16 Great Neck Road North <br />;i <br /> Mashpee, MA 02649 <br /> CITIZEN INTEREST FORM <br /> Today's Date Name: <br /> Y Street Address: <br /> j <br /> Mailing Address: <br /> Home Phone: Business Phone: <br /> Vfi <br /> Thank you for your interest in serving the Town. Please prioritize your interest in committees on the I� <br /> back of this form (i.e. preference 1, 2, 3, etc.)' <br /> I <br /> EXPERIENCE which might be helpful to the Town: <br /> EDUCATIONAL BACKGROUND which might be useful to the Town: <br /> I <br /> Are you available to serve on a Town committee/commission on a year-round basis? <br /> ❑ Yes ❑ No 'l <br /> If no, what is your availability? <br /> How did you become interested in serving the Town? <br /> ❑ newspaper ❑ friend ❑ self interest ❑ M1t:U <br /> The Search Committee suggests that you be aware of the time commitment you will need to make to <br /> ` the Committee/Board of your choice. If you need details on time commitments, please contact the <br /> Selectmen's office at (508) 539-1400. <br /> Please Return To: <br /> Board of Selectmen <br /> Town of Mashpee <br /> 16 Great Neck Road North <br /> Mashpee, MA 02649 lam} <br /> 4 <br /> 123 .t_ <br />