Date: November 2nd 2009

If you have any trustees whose term will be expiring and wish to be reappointed, please note that P.L.2009, c.141 requires them to fill out a Citizen Leadership Form. Likewise, if you have any candidates for an empty position on the board, please let them know that they need to submit this form.

Please check with your municipality to get a copy of the form.

 b.    (1)  Any person interested in service on a municipal authority, board or commission shall file a one-page form with the clerk of the municipality expressing interest in public service.
 (2)   The form shall be in substantially the following form however, a municipality may require the submission of additional information:

Citizen Leadership Form:

   I,                             , hereby apply to perform public service on the following municipal authorities, boards or commissions: 
              a) 
               b) 
               c) 
   1.  Name: 
   2.  Address of Residence: 
   3.  Phone Number: 
   4.  E-mail Address: 
  5.  Education, prior volunteer or work related experience, or other civic involvement which could be of use to authorities, boards or commissions: 
 (3)   Address, phone number and email address shall be deemed confidential for the purposes of P.L.1963, c.73 (C.47:1A-1 et seq.) and P.L.2001, c.404 (C.47:1A-5 et al.).

Victoria Rosch, Deputy Director Library Development Bureau New Jersey State Library vrosch@PROTECTED
609.278.2640 ext.157


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