Form Center

2. PDF Application

   Download a PDF copy of the Boards & Committees Application (PDF).

4. To the Town Manager, Board of Selectmen or Moderator - (Depending on Appointment Authority):
6. I hereby request to be considered for membership to the following board(s) and/or committee(s):*

   1. Planning Board
   2. Finance Committee
   3. Recreation Commission
   4. Sewer Commission
   5. Conservation Commission
   6. Zoning Board of Appeals

   1. Capital Planning Committee
   2. Community Preservation Committee
   3. Open Space Committee
   4. Economic Development
   5. Other
8. If other, please specify
10. If more than one, please indicate your preference: 1,2,3…
14. Preliminary Information
16. First Name*
17. Last Name*
19. Residence Address*
21. City
22. State
23. Zip Code
25. Residence Phone Number*
26. Email*
28. Business Address
30. City
31. State
32. Zip Code
36. Membership in Community Organizations
38. Organization 1
40. Dates
42. Activities
46. Organization 2
48. Dates
50. Activities
54. Organization 3
56. Dates
58. Activities
62. Organization 4
64. Dates
66. Activities
70. Additional Organizations?

    1. Yes
    2. No
72. Please describe additional organizations
76. Do you have any skills, experience, or training you would like to mention?*
78. What is your reason for wanting to serve on this Board or Committee?*
80. Are you registered to vote in Dracut? Please check one.*

    1. Yes
    2. No
Leave This Blank:


82. 1. Receive an email copy of this form.
83. Email address

    This field is not part of the form submission.

84. Submit

* indicates a required field