Board Appointment Application Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Email Appointment Applying for Please describe any relevant experience in the areas served by this Board Are you related to any current employee of Sylvania Township:* Yes No Are you related to any other member or employee of the committee, commission, board or agency for which you are applying?* Yes No Do you serve on any other public or not-for-profit boards?* Yes No Are you a defendant or plaintiff in any pending civil law suits that could impact your service on this public board?* Yes No Have you ever been convicted of a felony?* Yes No Signature of Applicant * I certify that the statements made by me in this application are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that any false statements will void this application and any actions based on it. Thank you!
