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Community Safety Working Group Interest Form
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Use this form to express your interest in the Community Safety Working Group
Thank you for your interest in serving for the Town of Amherst. The Town is dedicated to inclusive government and representing our diverse community through our appointments on Boards, Committees and Commissions.
Address (Example: 4 Boltwood Avenue):
Tell Us About Yourself
I wish to serve on the Community Safety Working Group because:
I have the following training, experience, and/or qualifications:
Other information that may help the appointing authority understand your interest:
How did you hear about this opportunity?
The following four questions are optional. The goal of the appointing authorities is to appoint qualified and interested Amherst community members who are broadly representative of the Town. Any information you provide in this section would aid us in that goal.
-- Select One --
Required: Please read the following and state that you understand and agree: The filing of this form does not guarantee my appointment. An application is kept on file for two (2) years; after that I must file a new Community Activity Form. Being appointed to a Town committee, board, or commission means that I am considered a Municipal Employee under MGL Chapter 268A and thereby subject to Conflict of Interest Law MGL Chapter 268A, Financial Disclosure Law MGL Chapter 268B, as well as Open Meeting Law MGL Chapter 39: Section 23B. I understand that I will take the conflict of interest test AFTER being appointed but BEFORE being sworn in by the Town Clerk. I will contact the appointing authority with any questions about my service.
I have read, understand and agree to the above terms:
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