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Mayoral Appointment Application Form

  1. **Applications may be submitted for consideration at reappointment time or when vacancies occur. They will remain on file for two years.
  2. If you are an active, dues paying member of a political party, please indicate that party:
  3. I hereby certify, in accordance with Fitchburg Ordinance 1.44(2)(B), that I do not hold stocks or bonds in any corporation subject to the jurisdiction of the Transportation and Transit Commission nor am I in any manner pecunialily interested in any such corporation. I also agree, that should I be appointed to the Transportation and Transit Commission, That I shall not acquire any investments in any corporation or organization that violates this section of the Ordinance during the term of my appointment. Signature:
  4. Are you currently serving on other Boards, Commissions, or Committees with the City of Fitchburg?*
  5. Have you served on a Board, Commission, or Committee in Fitchburg before?*
  6. Leave This Blank:

  7. This field is not part of the form submission.