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2. Town of Bloomfield Board/Commission Member,

   Thank you for serving as a volunteer on a Town of Bloomfield Board or Commission. Once your current term has expired, your seat will be considered open and residents of the town will be able to apply for the position. If you are interested in being reappointed and would like to continue to serve in your current capacity, please fill out the following reappointment request.

   If you are no longer interested in serving after your term expires please notify the Town Clerk's office at 860-769-3507.

   You may also print out the reappointment request (PDF) and mail or drop it off at the Town Clerk's office at Town Hall (800 Bloomfield Avenue). All online forms are automatically routed to the Town Clerk's office for processing. The Town Clerk then passes the forms on to the Town Council sub-committee, Committee on Committees, and they will be in touch with you regarding next steps.

   Please note - this form is for reappointments to a Board or Commission. You can also apply for the first time to a Board or Commission.

   See a summary of the Boards and Commissions in Bloomfield.

4. First Name*
5. Last Name*
7. Email Address*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Political Affiliation*
    -- Select One --DemocratRepublicanUnaffiliatedIndependentGreen PartyI'm not sure
18. Which Board or Commission are you reapplying for?*
19. How long have you been serving on this Board or Commission?*
21. Please tell us how you have been a contributing member to this Board or Commission:*
23. Why would you like to continue serving on this Board or Commission?*
25. In addition to your experience serving on this Board or Commission, do you have any other expertise or experience we should be aware of that is an asset to this position?*
27. Is there anything the town or Town Council can do to help this Board or Commission perform more effectively?
29. Is there anything else that you would like to share with us?
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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