TOWN OF GREENE 
COMMITTEE APPLICATION 
Name          Date    
Address          Phone     
Mailing Address                 
e-mail Address                 
Employer          Work Phone   
Please indicate any special qualifications or any experience that you may think many be hepful 
in your choice of Board or Committee: 
                 
                 
          How long a resident     
Please check area of interest 
  Appeals Board    Greene Community Scholarship Committee 
  Budget Committee    Capital Improvement Committee 
  Cable TV Committee (WGLT TV7)    Conservation Commission 
  Ella A Thompson Committee    Economic & Community Development Group 
  Julia Adams Morse Library    Fire Department Benevolent Fund 
  Greene Volunteer Fire Dept Auxilary    Land Use Ordinance Review Committee 
  Planning Board    Sabattus Lake Dam Commission 
  Solid Waste Committee    Parks & Recreation Committee 
Any Comments or suggestions: 
                 
                 
                 
Any known conflict of interest:       _____ Yes  _____ No 
Reason for application to this Board/Committee: 
                 
                 
I have _____/have not ____ attended at least two meetings of the Board for which application is being made. 
I agree to attend all meetings, except for sickness or emergency, and will advice the chairperson when 
I am unable to attend, if appointed. 
             
Signature of Applicant  Date 
Please return this form to Town Office, Town of Greene, 220 Main St, P O Box 510, Greene, Me 04236-0510
Phone (207) 946-5146, fax (207) 946-2102
For further information, please check Town of Greene website www.townofgreene.net
10/07