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2. DATE APPLIED
   DATE APPLIED

   DATE APPLIED
4. FULL NAME
6. Address
8. City
9. State
10. Zip Code
12. EMAIL ADDRESS

    Please only submit personal email address as others may be subject to disclosure.  

14. Personal Email Address*

    Please confirm this is a personal email address that you do not wish to be disclosed under the Open Public Records Act (OPRA).

    1. clerk@rockawaytownship.org
16. TELEPHONE NUMBER

    Please only submit personal email address as others may be subject to disclosure under the Open Public Records Act (OPRA).

18. BIOGRAPHY
20. CANDIDACY

    What makes your candidacy more compelling than others?  What experiences and skillsets do you bring to the table that makes your candidacy unique/compelling?  (NOTE: This does not guarantee your appointment as you may serve at the discretion of the Mayor or/with-the-consent-of-the Township Council).  

22. RESUME

    Please submit a resume, cover letter, writing samples, or any other documentation that you feel supports your candidacy.  (NOTE:  Please be aware resumes and other forms of documentation may be subject to disclosure under the Open Public Records Act/Common Law.  

24. Name
25. Address
27. Phone Number
28. Years Known
    Years Known Start Date

    —

    Years Known End Date
30. Name
31. Address
33. Phone Number
34. Years Known
    Years Known Start Date

    —

    Years Known End Date
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field