(YEAR  _________)	FOR THE TOWN OF: 											
	TOWN MAILING ADDRESS:									
												
	PHONE NUMBER:						 FAX#: 					
	E-MAIL ADDRESS:											
	OFFICE HOURS:											
	ANNUAL TOWN MEETING DATE: 								

Complete the preferred mailing addresses and phone numbers below. Often this is the home address for board members that are not in the office on a regular basis. Our records for mailing important correspondence and newsletters are compiled from this sheet. Thank you for your time.

TOWN MANAGER/ADMINISTRATIVE ASSISTANT:

NAME & TITLE			
ADDRESS				
			
PHONE 		FAX		
E-MAIL				

SELECTPERSON, TOWN COUNCIL:

CHAIRMAN			
ADDRESS				
			
PHONE 		FAX	
E-MAIL			

NAME			
ADDRESS				
			
PHONE 		FAX	
E-MAIL			
NAME			
ADDRESS				
			
PHONE 		FAX	
E-MAIL			

NAME				
ADDRESS				
			
PHONE 		FAX	
E-MAIL			
NAME				
ADDRESS				
			
PHONE 		FAX	
E-MAIL			

DIRECTOR OF PUBLIC WORKS:
NAME				
ADDRESS				
			
PHONE 		FAX		
E-MAIL			

PLANNING BOARD MEMBERS:

CHAIRMAN		
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

P.B. ALTERNATES:
NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			
NAME			
ADDRESS			
			
PHONE 		FAX	

TOWN APPOINTED REPRESENTATIVES TO HCPC FULL COMMISSION (2 Comm. & 1 Alt):

NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				

NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				

Alternate:
NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				
			
BOARD OF APPEALS MEMBERS:
CHAIRMAN			
ADDRESS				
			
PHONE		FAX		
E-MAIL				

NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				

NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				

NAME				
ADDRESS				
			
PHONE		FAX		
E-MAIL				

NAME				
ADDRESS				
				
PHONE		FAX		
E-MAIL				

TOWN PLANNER/PLANNING ASSISTANT: 
NAME				
ADDRESS				
				
PHONE		FAX		
E-MAIL				

TOWN CLERK:

NAME			
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

CODE ENFORCEMENT OFFICER:
NAME			
ADDRESS			
			
E-MAIL			

COMPREHENSIVE PLANNING COMMITTEE:
CHAIRMAN		
ADDRESS			
			
PHONE 		FAX	
E-MAIL			

PLUMBING INSPECTOR:
NAME				
ADDRESS			
			
PHONE 		FAX	
E-MAIL			
CONSERVATION COMMISSION MEMBERS:
CHAIRMAN		
ADDRESS			
			
PHONE 		FAX