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2. Police Community Advisory Board - Town Seat

   Term: Three-year term
   Appointment: Town Selectboard

   Contact: EPD Community Affairs and Public Information Officer Anthony Jackson-Miller; ajacksonmiller@essex.org; 802-857-0083

4. APPLICATION
6. First Name*
7. Last Name*
9. Street Address*

   You must be a resident of the Town of Essex or the City of Essex Junction to be considered. If you are a resident of the City of Essex Junction, please apply at www.essexjunction.org.

11. Mailing Address (if different from Street Address)
13. Email Address*
14. Phone Number
16. Why are you interested in volunteering for the Police Community Advisory Board?*
18. Do you have any personal aspirations that could be enhanced by your service on this board?*
20. Do you have any special skills, expertise, connections, or experience that you believe could be beneficial to the work of the board?*
22. VERMONT PUBLIC RECORDS LAW

    Under Vermont's Public Records Act, 1 V.S.A. §§ 315-320, any person has the right to request inspection or copying of a public record from government agencies, including municipalities. 

    Documents in the possession of public officials for municipal business are classified as public records and are available to the public unless excluded under the Public Records Act. 

    Applicants are discouraged from submitting information considered proprietary unless it is deemed essential for proper evaluation of the application. However, if the application contains information that the applicant considers to be trade secrets or confidential, the pages containing that information should be identified.

    Please note, some information in a public record may be redacted, narrowed, or denied in accordance with State law if it could reasonably be expected to constitute an unwarranted invasion of personal privacy.

24. 3. SIGNATURE: By typing my full name, I certify that I am at least 16 years of age and that I understand this application, with the exception of my address, email address, and phone number, is a public record and will be included in a public meeting packet for board consideration and public interview.*
26. 4. DATE SIGNED:*
    4. DATE SIGNED:
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field