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Wall Township Citizen Leadership Application

2. Wall Township welcomes our residents to volunteer in our community. We encourage our residents to offer their knowledge and insight by offering to serve on one of our boards or committees. If you have expertise in a particular field and a desire to volunteer, Wall Township needs you! Please fill out a citizen leadership form to become a member in any of our boards or committees.
4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone Number*
    *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.).
19. Email Address*
    *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.).
21. I Am Interested In Serving On The Following Board(s)*

    1. Board of Adjustment
    2. Planning Board
    3. Community Relations/Alliance Commitee
    4. Environmental Advisory Commitee/Green Team
    5. Citizens Commitee on Affordable Housing
    6. SMRRSA

    1. Mobile Home Rent Stablization and Control Board
    2. Recreation Advisory
    3. MRRSA
    4. Senior Citizen Advisory
    5. Economic Development Advisory Committee
    6. Health Advisory Board
23. Additional Information
    Please list any education, prior volunteer experience, work related experience, or other civic involvement which could be of use to the authorities, boards or commissions which you selected above
25. Date*
27. Signature*
    If I am selected to serve on the board(s) I will participate. Individuals appointed to serve on certain boards, commissions or committees will be required to comply with the requirements of the Local Government Ethics Law, (N.J.S.A. 40A:9-22.1 et seq.). Annual Financial Disclosure Statements. The Township Clerk will notify such individuals each year when their Financial Disclosure Statements must be completed and filed with the State of New Jersey.
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field