Please give your educational background, including any special courses related to this position.

Detail your occupational background and the names of your employers.

List past and present community and political service.

What is your understanding of the function of this board?

What do you hope to accomplish by serving?

Effective participation requires time for preparation, follow-up, and meetings. Do you have the necessary time available to serve effectively?

Have you ever served on a board or commission in Madison or another town? (If so, please indicate where and when).

Is there anything in your present situation or past that might constitute a conflict of interest in your service?

Do you own or are you employed by an enterprise that does business with the Town of Madison?