Community Academy Form

Please fill in the following application form.
Registration is tentative based on a "first-come, first-served"
to the first forty-five students and you will be contacted for confirmation.

Page 1 of 1

Name

Email:

Enter a valid email address. Example: name@company.com

Address

State

Zip

Contact Phone

Enter a valid phone number. Example: 123-456-7890

If you have ever served as a Town Volunteer, describe position and year(s):

Briefly state why you are interested in participating in the Community Academy:

Briefly provide professional background highlighting any planning experience or knowledge:

I understand and agree to to pay $50.00 either before or at our first class.

Yes

I understand and agree to not miss more than two (2) classes.

Yes

Please Note: There is a fee of $50.00 due at or before the first class to cover class materials that are yours to keep at the conclusion of the Institute. No refunds will be issued.