BERNARDS TOWNSHIP "TAP THE TALENT" VOLUNTER FORM

Personal
Information
Last Name   First Name    MI
Home Address   City   State   ZIP
Home Phone:  Work Phone:  Email:  
# Years Resident   Availability: Day   Evening   Daily   Weekly   Monthly
Education &
Professional
Information
Highest Degree  Major 
School    Present Employer 
Position 
Prior
Volunteer
Experience
Have you ever served as a volunteer for Bernards Township?
No Yes, if so please list
Agency                                                                   Year/Term


Other volunteer experience?
NoYes, if so please list
Agency                                                                   Year/Term

Board and
Commission
Interests
Agricultural Advisory
Board of Health
Deer Management Advisory
Environmental Commission
Fire Department
First Aid Squad


Fire or First Aid (Adminis.)
Flood Mitigation/LEPC
Golf Utility
Library Board
Municipal Alliance
Planning Board
Pool Commission

Rec, Parks & Pathways
Sewerage Authority
Special Task Force
Shade Tree Commission
Youth Services Comm.
Zoning Board of Adjustment
Other   If Other, please specify
Professional
Experience
&
Personal
Interests
Mark your areas of expertise or interest: (E-Experience; I-Interest)
  •   E      I
  • Arts & Culture
  • Beautification
  • Community Development
  • Community Services
  • Computers
  • Crime Prevention
  • Education
  • Environmental
  •   E      I
  • Government
  • Finance
  • Fire & Rescue, First Aid
  • Fund Raising
  • Health Issues
  • Historical
  • Landscaping & Trees
  • Library
  •   E      I
  • Leisure Learning
  • Open Space Preservation
  • Planning & Zoning
  • Recreation & Pool
  • Quality Management
  • Senior Citizens
  • Traffic
a HAVE YOU EVER BEEN CONVICTED OF A CRIME, including misdemeanors and summary offenses, which has not been sealed or otherwise cleared from your record? IF YES, EXPLAIN INCLUDING PERIODS OF REHABILITATION. (A yes answer is not an automatic bar to appointment.)
Additional
Information

Please add any information you feel would be helpful


I verify the information provided by me is true and accurate and by submission of this form I am indicating my interest in serving as a Bernards Township volunteer.
Date: 9/2/2014