Form Center

2. APPLICANT INFORMATION

4. First Name*
5. Middle Initial
6. Last Name*
8. Address*

   Street Address, City, State, Zip Code

10. Email Address*
11. Telephone Number*
13. What is your gender identity?
    -- Select One --FemaleMaleTransgenderNon-Binary/Non-ConformingI do not wish to self-identify
15. What is your race/ethnic background?*
    -- Select One --American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteOtherI do not wish to self-identify
17. Are you bilingual?
    -- Select One --YesNo
18. If you selected "Yes" what languages do you speak?
20. Are you a veteran?
    -- Select One --YesNoI do not wish to self-identify
22. Disability Status
    -- Select One --Yes, I have a disabilityNo, I do not have a disabilityI do not wish to self-identify
26. What special skills or knowledge would you bring to the Library Trustees Board?
28. Please provide any additional information you feel would be useful in considering your application.
32. Public Contact Information
    Under Massachusetts law, emails and text messages sent or received on private accounts for public purpose are considered a public record and will need to be produced if a public records request is made that encompasses such documents. The Massachusetts Office of the Inspector General therefore recommends appointees separate their personal contact information from their public official contact information to avoid issues with archiving and responding to Freedom of Information Act Requests.

34. If appointed, please provide the contact information you intend to use as part of your duties as a Library Trustee.

36. Email Address*
37. Phone Number*
41. Cover Letter *
43. Resume *
45. Note: Upon submission, this application becomes public record.
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field