Citizen Leadership Form

Citizens are invited to apply for service on the various committees, commissions, and boards in Highlands. Please read the statement below and fill in the form to apply.

I, [type name in form below], hereby apply to perform public service on the following municipal authorities, boards or commissions:

I also understand that citizens appointed to serve on Borough of Highlands Authorities, Boards, Commissions and/or Committees are subject to the regulations of the New Jersey Local Government Ethics law which may require the filing of a Financial Disclosure Statement.

Please note that any personal information entered 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.).

Name *

First

Last

First choice *

Second choice

Third choice

Applicant experience *

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 listed above.

Email *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Are you indebted or obligated, in any manner, to the Borough of Highlands except for current sewer or taxes? If yes, please contact 732-872-1224 x203. *

• Yes
• No

I understand I may have to file a Financial Disclosure Statement as noted at the top of this form. *

• Yes
• No

Submit