HomeMy WebLinkAbout2026re�SAV"
Name: Michael Robinson
Add rwase 21 Shields Street
Town of Mansfield
RI f I I'VET)
Application to Serve on a Bo6rd9? "C6Mmi ""(dIi,l
Telephone No. (Hoare) (508) 339-1214
C-Mail Address:
Committee or Study C> rnu' ,.
u.d �,,id .,.-I P i: !i2
Date January 7, 2028 1I
(Cell) t817) 913-7402
I. Are you a registered voter in Mansfield? Yes X No
Town Boards, Commissions, Corrrmittees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: School Committee- Interim School Corso Member
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Colmnillee
Planning Board
Recreation Colmmission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. School Committee- Interim School CmlooMember B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I have lived in Mansfield for 20 years and am deeply invested in our great community, especially the schools. I have three children who have
been enrolled In Mansfield Schools. I recognize there are many challenges and changes facing our school district and schools and I believe
1 may be able to halo
4. Please slate three attributes you can bring to this Board, Committee, or Commission.
Passionate Problem Solver: I enjoy challenges especially for areas I care deeply about.
Collaborative Style: my approach Is positive and focused On outcomefresults. I recognize great Ideas can come from putting all our ideas into cansidecdon
Dedication and Commitment:I am deeoly committed to education and to our community
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
yes
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I would want to assess after appointment to the role, but one area that I believe could benefit the committee and the community Is an enhanced bldoectional
communication model that both Informs and elicits more proactively and personalty to students, parents, leachers and staff, and community members
7. What is your availability? Nights? Weekends?
I am available nights and weekends
8. Do you regularly attend Town Meeting? Yes 0 No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes= No..O✓ _
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A.
It. Please list your present employer:
(Optional)
Employer: Position:
BCSSMA Digital Produ
Dates:
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
I am not an educator myself, but I come from a family of educators and am deeply proud of that. I volunteer with the Toureile Association of
America and through that work 1 have familiarity with the needs of special education students, in addition to having children with an IEP.
I am resourceful for information and research and can benchmark and Identify solutions that help other organizations solve challenges
they face.
13. Education Background: `}
Name and Location Graduated Degree(s)
(Yes or No)
High School: Saint Sebastian's School Needham, MA Yes High School
College: College of the Holy Cross Worcester, MA Yes B.A.
Other Secondary: Bentley University Waltham, MA Yes M.B.A.
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
Tourette Association of AmerPoa (MA Chapter Chair)
Eagle Scout and parent of current smut
16. Please provide any additional information you feel may be helpful while reviewing your
application.
4e40 od e5to—L .s(
fv/ LaZ3
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of 3120/13
�e
M
Town of Mansfield
Application to Serve on a Board, Commission,
Committee or StudyGrqup
Name: Chris Jackson
30 Danielle Lane Mansfield MA 02048
Telephone No. (Home) 401-440-1190
K-Mail Address: chrisdciackson@gmail.com
Date 3/19/2026
(Cell)
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference
A. toe B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I have served since 2020 and am renewing.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
My commitment to, extended experience with and leadership of the group.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Yes, nearly all since 2020.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
Not at this time.
7. What is your availability? Nights? Weekends?
Nights.
8. Do you regularly attend Town Meeting? Yes ]L- No _ L
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes _-M No _Q_
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. IDc
3
11. Please list your present employer:
(Optional)
Employer: Position:
Allsofino Global Investments. Associate Regional Director
Dates:
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
In financial services.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Bishop Henddcken Warwick RI (Yes)
College: Boston College, Chestnut Hill MA (Yes) BS Finance
Other Secondary:
14, Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Chris Jackson
Signature
Revised 3/21/13 per BSO Vole of 3/20/13
Town of Mansfield
(�(('Ito,
App�i�at}4n S,er!�o a Board, Commission,
/(7q Committee or Study Group
tUf'e .I !F,i, _ 1 `„.) 3: la
Name: Aaron Hyre
Address: 495 Ware St.
Telephone No. (Home)
E-Mail Address: aaronhvre(h)vahoo.com
`A
A.
I.
i
Are you a registered voter in Mansfield? Yes X
Date 01/04/2026
(Cell) 508-294-8418
No
Town Boards, Commissions, Committees:
Airport Commission
Historical Commission
Animal Welfare Committee
Industrial Development Commission
Board of Assessors
Library Trustees
Cable Access Board of Directors
Municipal Building Committee
Conservation Commission
Planning Board
Council on Aging
Recreation Commission
Cultural Council
WWII Scholarship Fund Committee
Finance Committee
Zoning Board of Appeals
Board of Health
Keep Mansfield Beautiful Committee
Please mark your two choices in order of preference:
3. Why do you want to serve on this particular Board, Committee, or Commission?
With many years of experience in public school administration, district operations, and educational
technologv leadership, I believe I can make a meaningful and immediate contribution during this
interim period.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
I have spent more than a decade in district -level leadership roles, collaborating with superintendents,
principals, teachers, town officials, and community members on budgeting, policy development,
strategic planning, and day-to-day school operations.
I bring an analytical approach to evaluating options, and supporting decisions that align with district
goals and student needs.
I value respectftd dialogue, clear communication, and teamwork
Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Previously, many years ago. Recently. I have watched meetings on cable access.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I'm interested in helping maintain continuity, and supporting the district's mission during this
transition.
What is your availability? Nights? Weekends?
I am available most nights and weekends with notice.
8. Do you regularly attend Town Meeting? Yes No X ( I did recently attended
the special Town Meeting)
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes No X
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A.
10
11. Please list your present employer:
(Optional)
Employer: Position:
Dates:
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
Deep understanding of school operations strategic planning budgeting capital planning and policy development
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School:
College: Eastern Nazarene College Yes Business Management
Other Secondary: Suffolk University Graduate Certificate, Local Government Leadership & Management
14. Please list any professional affiliations (Optional):
Massachusetts Educational Technology Administrators Association (METAA)
Massachusetts Municipal Association (MMA)
Massachusetts Computer Using Educators (MASSCUE)
IS. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel lnay be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of Interest'
provided by the Town Clerk, if appointed, and to the best of my ability agree to abide by
the provisions of the statute.
Lj j -
Signature
Revised 3/21 /13 per DSO Vote of 3/20/13
Town of Mansfield
4 Rr'E'11C��Epp.I��{VS OFFICE
Application to Serve on a Board, CO)71Itf4SSlY9n�
Committee or Study Gro% MAY 21 A 11: 51
Name: Bryan Haworth Date05/2112026 MANSFIELO
S_ TS
Address: 36 Lantern In Mansfield, MA 02046
Telephone No. (Home) (Cell) 506-496-9948
E-Mail Address: bryjhawOgmail.com
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Planning Board B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I have thoroughly enjoyed my time as an Associate Member of the Board, and have built a strong working relationship with the rest of the members of the Board
as well as our Director of Planning, Sarah Repass. I believe that this Board needs a representative voice from the generation of individuals who have been
impacted the most by the shortage of housing In this Commonwealth. I have driven many productive housing policy conversations In my f 1 months as an
Associate Member, and hope to have the chance to continue as a full Board Member.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
I have a deep curiosity of markets, and It forces me to dissect the mimed of forces contributing to the status quo as well as the potential second and third order
effects of potential actions. I am passionate about (rousing, and devote a large amount of my free time to growing my knowledge about the subject. I am reliable
when I make commitments, and have not missed a single meeting since I became a member of this Board.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
I have attended every meeting since I became an Associate Member in June of 2025.
G. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I would like to take a deeper look at our Zoning Bylaws and realty try to Interrogate which aspects of It are standing in the way of the town achieving the goals set
out In the 202 Master Plan. Much of the cleanup thus far has been procedural, focusing on redundancies, moot points, and expired clauses. While that Is still
important, it Is not expected to move the needle much with regards to the Master Plan.
7. What is your availability? Nights? Weekends?
Most nights and weekends. My allendance record shows that I take my commitment to the Board very seriously.
8. Do you regularly attend Town Meeting? Yes R No [I
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes Ft/-1 No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A Planning Board
B. Downtown Committee
Dates: 5/152025-Present
Dates: 10222025-Present
it. Please list your present employer:
(Optional)
Employer: Position:
True Talent Advisers Senior Director of Analytics
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
I have a deep understanding of Finance and Economics, and am currently the only member of the Board with a background In those disciplines. I am also very
well read on housing trends and strategies throughout the country, and frequently point to Iawstregulalla wAmfics that have worked elsewhere. As a professional
data scientist, I make sure to back up my positions with empirical evidence wherever possible. I will soon graduate the first cohort of the Massachusetts Housing
Leadership Academy, and as long as I am a member of this Board It will count as a Best Practice towards the EOHLCs Housing Choice Designation.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Somerset High School, Somerset, MA Yes HS Diploma
College: The Wharton School, University of Pennsylvania, Philadelphia, PA Yes B.S. Economics
Other Secondary:
14. Please list any professional affiliations (Optional):
MA Housing Leadership Academy
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I have a 19-month old daughter that I look forward to raising in this town. I am committed to helping make Mansfield the best place possible for her to grow up.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
�gi�tGre
Revised 3/21113 per Bi Vole of 3/20/13
RECEIVED
Town of Mansfield OWN CI_ERKS.OEf+ICE
Application to Serve on a Board, C i
at44'[�'1�1�� q'QP p I: 10
Committee or Study. Group
MAIN St-IELD
NU5ETTS
Name; t�(.tU rren 7CJ{��.!"4M Date: ..� �!. Yam_
Add a: 3 J Ia i2 g y D✓ l VIO
Telephone No, (Home) OOg a ("i� • ��
y (Coll).
E-MallAddresst M Au Qp'I ti I V
/�i ,, t
y Ul�%%CaSfi 1iE.7
1. Are you a registered voter in Mansfield? Yes No
Town Boards, Commissions, Committees:
Airport Commission
Historical Commission
Animal Welfare Committee
Industrial Development Commission
Board of Assessors
Library Trustees
Cable Access Board of Directors
Municipal Building Committee
Conservation Commission
Planning Board
Council on ftging
Recreation Commission
Cultural Council
WWII Scholarship Fund Committee
Finance Committee
Zoning Board of Appeals
Board of Health
Keep Mansfield Beautiful Committee•
PIeCi= w,Cr18r-Fund
Car"r",,Nee
2. (Phen:1y0/4
lessemark your two choices in order of preference:
A. B. - -
3. Why do you want to serve on this particular Board, Comtpittee, or Commission?
s 0 M sLr-
ttU'046,Opqkip4s
Q. Please state three attributes you can bring to this Board, Committee, or Commission.
0
S, Have you attended any meetings of this Board, Committee, or Commission? (Optional)
NO
6. Arc there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
NONE'^
7. What is your availability? Nights? Weekends?
e0Th
&, Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Commission a Town of Mansfield?
Yes e No F_
10, If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on: ,
A, t3El�J3,w&pd Dates:
BDates:
� M lcN `F'rY�ore;
11. Please list your present employer:
(Optional) ,
Employer: /yJA Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission, -
MM (ns7! C4,41 W Sidi 1 Is
�a
Name and Location Graduated Degree(s)
(Yes or No)
13. Education Background:
High School: CS
nOOZ t 4042SS' Ppi
Other Secondary:
W
14, Please list any professional affiliations (Optional): / ,
15. Please list any other specialized interests and hobbies (Optional):
K Please provide any additional information you feel may be helpful while reviewing your
application.
0?1 ,,S 81WOO.
o
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
s i4fkcclae� C22�1 c,4x;4e4
Revised 3/21/13 per BSQ Vote of 3/20/13
J�ja vf496 1 �9.3
Maureen DOHERTY
has acknowledged receipt
of the
Summary of the Conflict of Interest Law for
Municipal Employees 2026
JANUARY15,2026
CERTIFICATE NUMBER:
SEC-3600410948208
TATE:
iC3
Maureen DOHERTY
has completed the
State Ethics Commission Conflict of Interest
Law Training 2026
MARCH 2$ 2026 - _ CERTIFICATE NUMBER:
SEC-3600410950818
RECF_NFD
OFFICE
Town of Mansfield
8�"'ea=• °° Application to Serve on a Board, Commiss►on, P Z 35
Committee or Study Group R.-
Name: Shannon Dempsey Dalle 718/26
Address: 81 Pratt St. Mansfield, MA02048
Telephone No. (Home) N/A (Cell) 781-929s574
G-Mail Address: Shanndempseyfillgmall.com
Are you a registered voter in Mansfield? Yes YES No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Animal Welfare Committee B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I some as an alternata.on the AWC - my term expires December 31, 2027.1 would like to apply as a full member of the AWC.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
ins0ulional knowledge -having served as an alternate I am familiar with the Committees procedures and have a working relationship with exlsting members
I have a genuine commitment to animal welfare and hands on shelter experience
1 have a collaboretive approach -and solo, volunteer development- Mousing wmmunity students looking to Nifill sMool requirements or looking to foster cornmungy Involvement
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Yes - as an alternate I have attended many AWC meetings
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
Yes— I'd like to Improve communication and documentation around Individual animals' needs from shift to shift.
I've already been working with the Sheller Coordinator on simple tools like cage/room signage to make key Information visible In real rime, since many
volunteers and shift leads work only one day a week and daily emails alone can let Important details slip through the cracks.
7. What is your availability? Nights? Weekends?
Nights - an occasional weekend
Do you regularly attend Town Meeting? Yes No 1:1-
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes -EL No _Q_
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Animal Welfare Committee t Dates
B. Dates
I I. Please list your present employer:
(Optional)
Employer: Position:
Comtech Communiwilons/Aliedum Sr. Program Manager
12: Please list any skills or specialized knowledge you can bring to this Board, Committee 61
Commission.
Program management over... overseeing a complex, Integrated 911 system, a9W strong skills in mss functional conrdlnation and developing clear communication/
documentation protocols for time -sensitive environments. I also bring specialized, hands-on knowledge of shelter operations from my role as a weekly shift lead.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Needham High School Graduated
College: University of Vermont Graduated SA Major in Psychology, Minor In Mathematics
Other Secondary: Northeastern American Sign Language Certificate Northern Essex Deaf Studies & Interpreting Certificate
Id. Please list any professional affiliations (Optional):
Project Management Professional (PMP)
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel lady be helpfitl while reviewing your
application.
I am passionate about providing a safe, clean environment for shelter residents and visitors, helping people connect with animals In our care,
and supporting a community shelter where volunteers can also supped the community and give their time toward animals in need.
I look forward to continuing this work as a full voting member of the Committee.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Z
Signature
Revised 3/21/13 per BSO Vote ol'3/20/13
Shannon Dempsey AWC Full Member Application
1. Yes
2. Animal Welfare Committee
3. I serve as an alternate on the AWC -my term expires December 31, 2027. [would
like to apply as a full member of the AWC.
4. Institutional knowledge -having served as an alternate I am famILiar with the
Committees procedures and have a working relationship with existing members.
I have a genuine commitment to animal welfare and hands on shelter experience
I have a collaborative approach - and enjoy volunteer development - including
community students looking to fulfill school requirements or looking to foster
community involvement
5. Yes -as an alternate I have attended many AWC meetings
6. Yes —I'd like to improve communication and documentation around individual
animals' needs from shift to shift. I've already been working with the Shelter
Coordinator on simple tools like cage/room signage to make key information visible
in real time, since many volunteers and shift leads work only one day a week and
daily emails alone can let important details slip through the cracks.
7. Nights -an occasional weekend
8. Yes
9. Yes
10. Mansfield Animal Welfare Committee
11. Comtech Communications/Allerium Sr. Program Manager
12. Program management experience overseeing a complex, integrated 911 system,
with strong skills in cross -functional coordination and developing clear
communication/documentation protocols for time -sensitive environments. I also
bring specialized, hands-on knowledge of shelter operations from my role as a
weekly shift lead.
13. Needham High School —Graduated
University of Vermont — Graduated BA Major in Psychology Minor in Mathematics
Northeastern University Certificate in American Sign Language
Northern Essex Community College Certificate in Deaf Studies and Interpreting
14. Project Management Professional (PMP)
15. N/A
16.1 am passionate about providing a safe, clean environment for shelter residents and
visitors, helping people connect with animals in our care, and supporting a
community shelter where volunteers can also support the community and give their
time toward animals in need. I took forward to continuing this work as a full voting
member of the Committee.
Town of Mansfield
Application to Serve or, a Board, Commissfog, ji-N _ , A
Committee or Study Group
Name:
I ' VI (' L H/ f U Q Date '...
Address: l0 V (�I �G� Rf
Telephone No. (Horne) t bh — 'S 3 7 (Cell)
E-Mail Address:_
\N Iy o Q Q G ct m G G �, C dtM
Lj
1. Are you a registered voter in Mansfield? Yes�_) No
Torun Boards, Commissions, Committees:
Airport Commission Historical Commission
Animal Welfare Committee Industrial Development Commission
Board of Assessors Library Trustees
Cable Access Board of Directors Municipal Building Committee
Conservation Commission Planning Board
Council on Aging Recreati(n Commission
Cultural Council WWII Scholarship Fund Committee
Finance Committee Zoning Board of Appeals
Board of Health , IKeep Mansfield Beautiful Committee
Other: �i y 6 I Y. Pt, IY`l a✓r
NeFw�^i< Pfe,n eOVnw+e
2. Please nark your two choices in order of preference:
A. B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
Go
c Vv" Vkl� k. V-S.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
W,'fl foy Fx:) Cie ��ti ✓t 1
to re A; (mod (oy
S Ue S
ASS
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
'Uv VVgt Vl::J
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
7. What is your
//availability?
,Nights? Weekends?
n n-0, hv.,r J, czv 1,` M 1�- kJ � CL0J' kO
8. Do you regularly attend Town Meeting? Yes No --E_
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes +/ No..�
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on: /� (I /t
✓3
A. I(e e,4 v V'04'76 dl 6m C Ql7 I'1 Dates:
( C� M i' �- f r.
B. Dates:
]I. Please list your present employer:
(Optional)
Employer: Position:
m i c h a s t o 6 v? tF L�o vvt �-- V-
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location Cli'aduated Degree(s)
(Ye or No)
High School:
College:
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpfid while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
gnat4e.
Revised 3121/13 per BSO Vote of 3/20/13
r2
IVE
Town of Mansfield! ICE
Application to Serve on a Board, 6V6Miisfl9n,'\ 11: 30
{� snob
Committee or Study Group
Name: T rw. -Ai G P) lAl • J a C4 a Date ► I
Address: 6� n�. V)at- -�'-
Telephone No. (Hone) `j C' - `3Sf P (Cell) _
C-Mail Address: to j V VVIctC O c/t
I . Are you a registered voter in Mansfield? Yes No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zuni Board of Appeals
Keeti Mansfield Beau r u ommr
2. Please mark your two choices in order of preference:
A. B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
el F✓eIrin &'r,Su3. 161'r-i9 .
4. Please state three attributes you can bring to this Board, Committee, or Commission.
r a e)'x kowe. M tD e.r.
Lti 5//r. I- Stir, ✓+%e.nS Mdr�a Gnu: AIL
�nm e,n
5,� 9 ha t � 6 �G
opt? /D AG u9 /9 va.S
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
J
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
7. What is your availability? Nights? Weekends? tp 4y
O 1_ tl.. 4-ow i
8. Do you regularly attend Town Meeting? Yes -1�1 No
9. Have you ever served on a Board, Committee, or Commissio!Lln the Town of Mansfield?
Ies No E-1_
10. if you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates:
B. Dates:
i I. Please list your present employer:
(Optional)
Employer: Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
t:
13. Education Background:
Name and Location Graduated Degree(s)
/ (Y es or No)
High School: _
College:
Other Secondary:
14. Please list any professional aft Cations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
i O 6 r Cr to o J S 6) lc— C/tJ•__(0 0 0 C4 G✓l
m
C9 �1d 6 n V O� f ad S �G S
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per 6SO Vote of 3/20/13
Town of Mansfield
+xa�� Application to Serve on a Board, Commission,
Committee or Study Group
Name: Steve schoonvam Date April6.2026
Address: 21 Newton Street. Mansfield MA 02048
Telephone No. (Home) 774-266-0363 (Cell)
E-Mail Address: s_schoonveld@yahoo.com
1. Are you a registered voter in Mansfield? Yes N No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Otter Non -Profit Gift Fund
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A Non -Profit Gift Fund B.
3. Why do you want to serve on this particular Board, Committee, or Conmussion?
Have always appreciated the committee and this is an area where I can support others.
a. Please state three attributes you can bring to this Board, Committee, or Commission.
I know how Town govemmenl works,
I have supported non -profits In town for many years.
This is an area where I can provide support for our residents and those in need.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Yes, years ago.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
Ensure we are following the requirements of the use of funds and Increase the source of funds from community donations.
7. What is your availability? Nights? Weekends?
The Committee meets just a few times a year, I can be available,
8. Do you regularly attend Town Meeting? Yes Z No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes No=
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. school Committee Dates: May2023-Dec2025
B select Board Dates: May2010-May2022
H. Please list your present employer:
(Optional)
Employer: Position:
GCG Consulmols Owner
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
Quickly able to understand regulations and legal provislons. strong budgeting aptitude.
13. Education Background:
Name and Location Graduated Degrec(s)
(Yes or No)
High School: HIM Oak lawn,IL, Y
College: Wheaton collage, Wheaton, Y, es
Other Secondary: isu, No.A Y. Ms
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of 3120/13
�awwry I11I'I)
RED _
Town of Mansfield r' ICE
°`e�axaw' Application to Serve on a Board, Comf►ss'"on, I 0
Committee or Study Group ''
i 11
Name: Almalacheh Date 01/08/2028 I i
Address: 112 Highland Ave. Mansfield MA 02048
Telephone No. (Home) (Cell) 181-985-1092
E-Mail Address: afma8281ma@holmall.com
Are you a registered voter in Mansfield? Yes Yes No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
other: school Committee
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in older of preference:
A schoolcommhte, B.
3. Why do you want to serve on this particular Board, Committee, or Cominissiom7
I have experence in working With educators. I direct a cultural center and its language 8 musk school In Beaton; I have expedence In lundralaing and grant writing
I lddeM1 Inlerrdtlorldl lbNdM NMure81 Na UnNaraiiydtlro Hdy GrDR4 NN dt WPI, erA I dmdn aN¢ITy¢tlleni8 Cholyd'.reIXW.2 yeM¢Sap, 16erved Mlle Mdnsfab acM1W mldglgrdM v1¢.pY
m,v,hee. nnbn, Ph. a undennanft of.ur I.reds erd I W. Ne school Cm .ran Sena(tlmmnryevpertlsae¢petlanyMry'ldea andargecla Nelensum. ha"M.
and Thal ante and .lure era nourished at our sdods. My Widmn era 4th and 3W graders al Jordan Jackaon school, therefore, I am very Involved in [he ManafieU eemect,
4. Please state three attributes you can bring to this Board, Committee, or Commission.
-1 can work With the school committee on policies and projects that ensure an Inclusive culture where students feel that they belong and can contribute gmately.
My experience as educator and arbs1 can serve the Interests of the schools, students and teachers.
-tam currently a member of the Wherein Local cultural Council, and other Infiesves in town, and I was pad of the school mission and vision committee.
Therefore. I can play a role In keeping the school committee connected and Involved in Manaeeld's community on the grassroot level.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Yes
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I am happy to vnek with the school Committee members to keep Improving our students educational and social experience and make sure that
our leachers and administrators are well equipped with everything needed to give the studonts what moy need for their success.
7. What is your availability? Nights? Weekends?
I am available during weekdays In the evening.
8. Do you regularly attend Town Meeting? Yes _Z_ No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes No_F-1
10. if you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A Mansfuldl.ocal Cuhuml Couail Dates: January 2023 to present
B. Dates:
it. Please list your present employer
(Optional)
Employer: Position:
Center for !rabic Culture Execullve Director
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
-I have extensive experience in working with communities of diverse cultures and backgrounds because of my previous work at the
United Nations High Commissioner for Refugees in Syria and my current work at the Center for Arabic Culture In Boston.
- I am a grant writer, and I hold fundralsing campaigns on regular basis.
-1 am an experienced artist. I direct an 80.member chair and music ensemble
13. Education Background:
Name and Location Graduated
(Yes or No)
High School: Al Maouneh School In Damascus- Syria
College: Damascus University -Law School
Other Secondary: ^'""'ten wmanay-waanlaelon c"Ilaea orinw
14. Please list any professional affiliations (Optional):
Yes
Degree(s)
baccalaureate
Yea BA In Law
Y. LLM. Mattes in lnlamatbrsl Legalmudas
15. Please list any other specialized interests and hobbies (Optional):
I play the piano and sing.
I direct Jazel Choir and an
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I am a member of the Mansfield Elementary School Association (MESA). However. if I am accepted at the School Committee. I will leave the MESA board
because of potential conflictof interest. I am also a member of the Mansfield Local Cultural Council. lam happy to stay there if there Is no cmdUct of olerest.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 net aSO Vote or3/20/13
Town of Mansfield
Application to Serve on a Board, GoninjiW c�nntIl 0
t 0 1 r
Committee or Study Groin?I�.'ff CI r � �,.� JnlryE
Nanle: Michael Parsons
AddreSS: 576 N Main St, Mansfield
Telephone No. (Horne)_
C-Mail Address: parsonsmike@gmaii.com
ZOA Just 12 P 2: 40
Date 1/12126
r r�
(Cell) 603 828-5887
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Otller: Bicycle 8 Pedestrian Network Plan Committee
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your live, choices in order of preference:
A. Bicycle & Pedestrian Network Plan Committee B.
3. Why do you lvant to serve on this particular Board, Conaniltee, of Commission?
I am an avid cyclist, and in the 12 years I've lived in Mansfieltl, I have cycled thousands of miles on the streets of Mansfield and surround towns.
I am convinced that with a little attention, effort, and some small changes, Mansfield can be a very sale town for cyclists of all ages and skill levels.
i would like Mansfield to be a town where parents feel safe telling their children bicycle to school, or to a friend's house, even if they live across town.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
As mentioned above, I am a very experienced cyclist with a significant knowledge of the bicycling conditions in town.
I have an extensive background in conflict resolution, group decision -making, interpersonal communication, and public speaking,
which are necessary skills for the success of any town board.
I am highly invested in the future of our town. I have a 4th-grade daughter, and I want Mansfield to be, as sale and welcoming for children as possible.
5. Have you attencled any meetings of this Board, Committee, or Commission? (Optional)
To my knowledge this hoard is new, and I was lust recently made aware of its existence. It It had existed and I had known about it earlier,
I vrould certainly have attended. I regularly attend Torn Meeting and have also attended numerous Planning Board meetings.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I have many ideas about small changes the town can make to dramatically improve the safety of transiting the town on toot or bicycle
at minimal cost to the taxpayers.
7. What is your availability? Nights? Weekends?
I'm a business cons -hunt. and my working hours are largely restricted to 9 5 1 could almost always awonwdate evening and weekend meetings.
S. Do you regularly attend Town Meeting? Yes Z No ❑
Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes F-� No _[Z]
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates
B. Dates
11. please list )rout- present employer:
(Optional)
Employer: Position:
Sell Employed as a Communication Consultant
12: Please list any skills or specialized knowledge you can bring to this Board, Committee of
Conunission.
Exped-level knowledge of the bicycling experience in Mansfield
Expert in the various communication skills necessary to optimize the process and outcomes of committee work.
i
13. Education Background:
Name and Location Graduated Degiee(s)
(Yes or No)
High School: Oyster Rivet HS, Durham NH. Graduated 1999
College: Marist College, Poughkeepsie NY, BA 2003
Other Secondary: wake Forest University, MA 2005, Ohio University, ON, PhD 2011
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional)
16, Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Cleric, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per t3SO Vote of 3/20/13
Signature
f CI Ir
' Town of Mansfield uNro RECEIVEDery !'OWN CLERKS OFFICE
o,Y.U,y Application to Serve on a Board, Commission,
Committee or Study Group 101b MAY 12 P It 18
t'lAIN ;FIELD
Michael Parsons 5/11/2026 � � ll t� �- S F 1 T S
Name: Date
Address: 576 N Main St.
Telephone No. (Home) N/A (Cep) 603-828-5887
E-Mail Address: parsonsmikeOgmail.com
Are you a registered voter in Mansfield? Yes X No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A Planning Board (Associate Member) B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
See attached page.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
See attached page.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
page
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
See attached page
7. What is your availability? Nights? Weekends?
attached
8. Do you regularly attend Town Meeting? Yes Z No ❑
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes _E:V:] No _F
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Bicycle/Pedestrian Network Committee Dates: 3/26 - Present
B. Dates:
11, Please list your present employer:
(Optional)
Employer: Position:
Self - Communication Consultant
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Nance and Location Graduated Degree(s)
(Yes or No)
High School: Oyster River HS, Durham NH, Class of'99.
College: Marist College (now University), Poughkeepsie NY, BA in Communication, Graduated'03
Other Secondary: Ohio University, Athens OH, Ph.D. in Communication, Graduated'13
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
See attached page
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per BSO Vote of 3/20/13
3. I've been in Mansfield for 13 years now, and I feel like I finally have an adequate
understanding of the pain points and fractures created by the built environment in our
town, but also the opportunities for connection and community that can be generated if we
build the town well for the future. The Planning Board is the right place to give my time and
effort back to the town to improve the everyday experience our current residents, while
making Mansfield a welcoming place for the next generation of families to settle.
4. 1 have extensive experience with the communication skills necessary for the efficient
functioning of any town board - conflict resolution, negotiation, group decision -making
processes. As an avid cyclist, I am intimately familiar with Mansfield as it exists at low
speed, experiencing the town as it is from outside of a vehicle, not just as a destination to
visit and depart once my task is completed.
5. 1 have attended numerous Planning Board meetings in recent years, and have been an
active audience participant, especially in the discussions regarding the TOD overlay zone
and the planned train station redevelopment project.
6. I'd like to see the Planning Board increase its consideration of the needs of non -drivers
as part of the normal course of business. Many Mansfield residents are not drivers due to
choice, or as a matter of age, (dis)ability, and/or cost. Many more are drivers but often
choose to transit the town on foot or via bicycle. The more the town can do to account for
the needs of this population as it crafts the public spaces the better off we will be in the
future.
7. 1 am reliably available on the Planning Board meeting dates, and can have reliable
availability on many other weekday nights and weekends given appropriate notice.
12. As mentioned above, I have extensive experience in the communication skills
necessary for the ideal functioning of boards such as this, and my cycling experience gives
me an uncommon perspective on how we can craft our town to generate the community -
building interactions we want to foster.
16. Finally, Mansfield is where my wife and I have chosen to make our home and raise our
daughter, who is now 10. Every time I see a young couple with a toddler, I wonder if
Mansfield is going to treat them as well in the next 10 years as it has treated my family in the
past 10, and I am reminded that such an outcome doesn't happen by accident - it is
designed and implemented by people who put in the work to make it real.
q gVwr p
Town of Mansfield RECEIVED
�° Application to Serve on a Board, Cominiss on,,
0OF DICE
Committee or Study Group Ifib .j,,Jl. -2 A (� Dq
Name: SaravananKaruppusamy D4ite6118/2026 ?,+:-;'ri`,,'>s(,I�aIsETTs
27 Cobbler Road Mansfield MA 02048
Telephone No. (name) 8572728128
(Cell) 8572728128
C-Mail Address: salemsarao@yahoo.com _
Are you a registered voter in Mansfield? Yes Yes No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: Audit Committee
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
t
2. Please mark your two choices in order of preference:
A. Audit Committee
3
3. Why do you want to serve on this particular Board, Committee, or Commission?
Continue to serve the Town of Mansfield in my current capacity and give back to the community.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
Accounting and Financial reporting knowledge
Internal controls and external audit oversight
Prior experience in handling audit committee matters
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Sitting member of the audit committee for the Town of Mansfield
6. Are there any changes you world like to make if you are appointed to this Board,
Committee, or Commission?
Continue to work with town and support sustained development and growth of our town
7. What is your availability? Nights? Weekends?
Yes - Both
8. Do you regularly attend'rown iVleeting? Yes 0 No Z
9. Have you ever served on a Board, Committee, or Commission in the Town of btansfield?
Yes.-M NoF-1_
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Audit Committe Dates: Nov 2024 through June 2026
@3
I I. Please list your present employer:
(Optional)
Employer: Position:
Ernst and Young (EY) Partner
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
CPA, CFA and experience in the external audit execution and oversight
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Saradha Bala Mandhir High School, India
College: University of Madras (Undergraduate Engg) and Anna University (MBA) - Both in India
Other Secondary: _
14. Please list any professional affiliations (Optional):
CPA and CFA
15, Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
Would like to continue my journey in supporting our town of Mansfield
1 will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Saravanan.Karuppusamy
Signature
Revised 3121/13 per BSO Vote of 3/20/U
Town of Mansfield RECEIVED
QWR CLERICS OFFICE
Application to Serve on a Board, Commission,
` Committee or Study Group 108 HAY 1 I A Nt 55
NA ISHELD
Name: Sally Fehervari Date May 10 202eA. � TTS
Address: 86 Lawndale Road
Telephone No. (Home) _ _ (Ce1g508-241-2948
c-Atau Address: s fg ehervari mail.com
Are you a registered voter in Mansfield? Yes X No
Town Boards, Commissions, Committees:
Airporl Commission
I-lislorical Commission
Animal Welfare Commiliee
Industrial Development Commission
Board of Assessors
Libiary''Pruslees
Cable Access Board of Directors
Municipal Building Committee
Conservalion Commission
Planning Board
Council on Aging
Recreation Commission
Cultural Council
WWII Scholarship Fund Commiliee
Finance Committee
Zoning Board ol'Appeals
Board off lealth
Keep Mansfield Beautilid Committee
Other: Bicycle and Pedestrian Safety Planning Comm
2. Please marl. your Iwo choices in order of preference:
A. B.
3. Why CIO you want to serve on this )arlicular Board, Commiliee, or Commission?
My husband and I have been Mvclinq in Mansfield for many, ma
committeeand-the-conversation-about -how-to -encourage-bicyclingrplan----
---infrastructure, and -inform -the -public —about -bike -and -pedestrian safety-
4. Please slate three attribules you can bring to this Board, Committee, or Commission.
I am organized enjoy workik n p»�e�and love bicycling and walking
S. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
I attended the April 30th Intro session presented by
man and Maya Couto & PAD_
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
Not at this time, as we are only starting our work.
7. What is your availability? Nights? Weekends?
Anytime.
8. Do you regularly attend Town \fleeting? Yes X No
9. Have you ever served ou a Board, Committee, or Commission in the Town of Mansfield?
Yes _}�_ No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Cultural Council Dates:2015-2020
B. Open Space and Rec Comm Dates: 2021- present
It. Please list your present employer:
(Optimml)
Lmployer: Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
In the Open Space Comm I have acquired planning skills through our
wor coon the Open Space PTan. also -I have an interest In ow to create_=
orban�nvironments_where reside nts_can-safely-bicycle and alk._.___
n
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
tlignsebool: Pittsfield High School, Pittsfield, MA Y _ Colleae_P_Cep
College:. New England Cons Y BA Music Performance
Other Secondary: BOSWP College N _ MBA
Id. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please Provide any additional information you feel may be helpful while reviewing your
application.
1 will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per aSO Voteol'3/20/13
5
Town of Mansfield
202b 3: 0U
Application to Serve on a Board, Commission,
0 Committee or Study Group, f' f f-1 D
Name: Lee -Ann I Ye, `` Date /�.3 -2y-2(o
Address:_ 5(� S�prlv\.ct 54., hQy\5 Ij. Mkt /) 2o4 g
Telephone No. (Home) l (Cell) S 2 � - L/1-/(o -0 167
E-Mail Address: i1'1r,,, f.I I �R. � sx!n ' . COMA
1. Are you a registered voter in Mansfield? Yes _V,' No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health (� 1
Other: 'R,64w-A at K 2 y1SkyAxS
Historical Commission
Industrial Development Cormnission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. OIZC� () 12 r tS_�AY B.
3. Why do you want to serve on this particular Board, Committee, or Cormnission?
4. Please state three attributes you can bring to this Board, Committee, or Commission.
A:.k.
oA
uw
S. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
6. Are there any changes you would like to make if you are appointed to Obis Board,
Committee, or Commission? ((���� _� ' -- ^
T— 0V\Ii a0c✓ce 0_ r�LkGS (COY CAW�--
COVQ n ��
7. What is your availability? Nights? Weekends? 1�
� O.ryy,-
wo v.e o d oCi
8. Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Commnission in the Town of M s6eld?
Yes � No
10. If you answered "yes" above, please list the Boards, Cmmnittees, and/or Commissions you have
served on:
A. Dates:
B. Dates:
It. Please list your present employer:
(Optional)
Employer: Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location
n 11 11 t � 1
High School: )'I VW"J 1YIcL mn� h ��U
College: « k\yv.T lA " 0I�(
Other Secondary: t 7 (1 j 4 Q t t1a�W lS"1 1 e
14. Please list any professional affiliations (Optional):
Graduated
(Yes or No)
V
VI
Degrees)
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of 3120/13
Name:
Addres
Telephone No. (Home)
K-Mail Address:
Town of Mansfield M - t'I,CI . F iCE
Application to Serve on a Board, ComnliI ipp, ,``1 F s,I: a
C 'tt St d G
omm> ee or u y roue
(Cell)yi_0l1' 3UQ
1. Are you a registered voter in Mansfield? Yes No
Town Boards, Commissions, Committees:
Airport Commission
t/Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Aw C_
3. . Why do you want to serve on
particular Board, Committee, or Commission?
. .. I _ a_.......i I
ConlYula��tiv1 y in JO Lu^ C)LA Wl W 6-1.I 1 S, Vv i
4. Please state three attributes you can bring to this Board, Committee, or Commission.
zeV k' r I:,c, vt he (I'DIVI
Cc� t
MAGflhx 11Iek
V off
f e'vp G
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
G. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
7. What is your availability? Nights? Weekends?
8. Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes,_ No _L]_
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on: n
A. 1A v L Dates:
B. Dates:
it. Please list your present employer:
(Optional)
Employer: Position:
V) 5
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location Graduated Degree(s) p
(Yes y of D No) n �-��(A�j uDO 6)p�OVllG�
High School:
College: ,)(HIV— "?k ]-U D
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21113 per nSO Vote of 3/20/13
Town of Mansfield
a 'e
a"'r^ sAofss4 Application to Serve on a Board, Commission,
Committee or Study Group
Name: Marcla Szymanski Date3//612028
Addreccc 29 Pleasant Street Mansfield MA 02048
Telephone No. (Home) NIA
l: Mail Address: remciaszymanski@gmall,cum
(Cell) 50846"025
1. Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: Boardof Registrars
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Board of Registrars B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
Now that I am retired I am Interested In public service and I have an Interest in the election process.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
1. Strategic thinker
2. Underslandln0 of systems
0. Coalition building and networking
S. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
I have attended Set.( Board meetings In the past, but none recently. I have not attended any meanings of the Board of Reglsmm.N
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
None at present because 1 donl have an understanding of how they currently operate.
7. What is your availability? Nights? Weekends?
Vades. i am generally available nights, not as much on weekends.
8. Do you regularly attend Town Meeting? Yes -Z- No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes= No ✓V "
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates
B. Dates
11. Please list your present employer:
(Optional)
Employer: Position:
RETIRED
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
Policy development and program planning.
Understanding of how government functions
13. Education Background:
High School: Immaculate High
College: Emmanuelcollego
Name and Location Graduated Degree(s)
(Yes or No)
New Waans, LA - Yes
Boston Yes BA, Religious Studies
Other Secondary: Bu Boston Yes Masters' Social Week
14. Please list any professional affiliations (Optional):
I serve on the Board of Directors of Iwo organizatIons: 1. Aldebom Ada Museum and 2. Jana Doe Inc.: Coagtlon Agalnsl sexual and Domesgc Violence
15. Please list any other specialized interests and hobbies (Optional):
Poetry and cn afve willing.
16. Please provide any additional information you feel may be helpful while reviewing your
application.
When I lived In Plainville I served a term as the SRPEED representative
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
IMF:
Signature
Revised 3/21/13 per BSO Vole of 3/20/13
RECEIVED
Town of MansON CI ERKS) OFFICE
�an4sxa ' Application to Serve on a Bc7AAdj49okonWsiqn4I
Committee or Study GrS( IEL D
M'A, SAC;IUSETTS
Name: Cameron Symonds Bate g11412026
Address: My S Main St
Telephone No. (Home) 5084091281 (Cep) 5084091281
E-Mail Address: camoron.symonds@ouf ook.com
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A Finance Committee
B.
3. Why do you want to serve on this particular Board, Committee, of, Commission?
1 nm caxeMail about Mansfiakl's recut health, budget priordus, and long term financial stability and I want to commands directly to the lawns
fiscal health and help ensure that our lax dollars are spent wisely a" transparently. I me anmyrcot by nature, dela4 redundant, and tomnatted to
non prefron decision making. Serving on flneom would aloe me to apply my sells in financial review and problem solving to help the lawn
overtone Its cement financial challenges.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
I am an exparlemmi technology leader vAth a long track record of schlevbg slgnlficanl reductions In operating expenses.
I have strong analytical and financial skill to assist with budgeling, implememig cost controls, and making data driven decisions.
1 work eel will, others, are Wounded to listening to different viewpoints, and will bang a progmel'x: approach to solving complex issues.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
No
G. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
l
Nel et this Ilma
7. What is your availability? Nights? Weekends?
Available most weeknights and weekends if planned ahead.
8. Do you regularly attend Town Meeting? Yes FV1 No n
9, Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes = No F71_
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates:
B. Dates:
It. Please list your present employer:
(Optional)
Cmployer: Position:
lodwArial Calendar Cimctor of IT
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission,
spools toohnolWy skills. 20 year residont of Mansfield
Knowledge of AI and analylics (hmh professbnalty and ecademicaly though the MBA pogrom)
13. Education Background
Name and Location Graduated Degrec(s)
(Yes or No)
It igh School: Toppor Ii High School TupporL ko, NY Yos Diploma
College: Clarkson Unlvemlty Potsdam, NY Yes Bachelor of Sciance(mmently pumulna MBA)
Other Secondary:
14. Please list any professional affiliations (Optional):
is. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signalur
Revised 3/21/13 per BSO Vote or3120/13
a
Name: Edith Sullivan
76 Williams Street
Telephone No. (Home) ...
ovdH cEi�E�KE� OFFICE
Town of Mansfield S
Application to Serve on a Board, Comm1wo 21
Committee or Study Group
E-Mail Address: edie.fedden@gmag.cone
Date May 27, 2026
(Cell) 617-816,6347
1. Are you a registered voter in Mansfield? Yes X No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Planning Board B. Bicycle B Pedestrian Network Plan Committee
3. Why do you want to serve on this particular Board, Committee, or Commission?
I am Interested in serving on the Mansfield Planning Board because I care about how our community grows and evolves. Mansfield has excifing ongoing
development initiatives, zoning updates, and oppodunNes tothoughtfully balance growth with preserving the character of the town. From a personal perspective,
I am drawn to roles where I can contribute to strategic dedslon-making, consider multiple stakeholder perspectives, and help shape long-term outcomes. The
aw�maee.,eoan.envw,wnw:awwe,,... me nmmvm.s.mna e. ra a�y.... mvmrca.:..
4. Please state three attributes you can bring to this Board, Committee, or Commission.
Andielcai dedslon-making Ability to review detailed maledais, synthesize Information, and identify key risks and tad"Ifis
Stakeholder engagement: Experience balancing competing perspectives and (soldering thoughtful, constructive dialogue
Clear communication: Ability to 0anslate complex concepts Into practical Implicatons for different audiences
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
G. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
At this gme,1 do not have specific changes I would propose. I would want to first gain a deeper understanding of the Board's current priorities,
processes, and ongoing Initiatives before forming recommendations.
7. What is your availability? Nights? Weekends?
Free after 5.30pm most week nights and very flexible on weekends.
8. Do you regularly attend Town Meeting? Yes F/I No D_
9, Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes fj No _0✓ _
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates:
B. Dates:
it. Please list your present employer:
(Optional)
Employer: Position:
Goodvrin Procter LLP Director, People operations and Anal}4ics
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission,
As an HR professional, I bring strong experience facilitating difficult conversations and navigating differing Perspectives. I am comfortable engaging In thoughtful,
respectful dialogue and working toward balanced outcomes when stakeholders have competing priorities.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Brookville High School, Lynchburg, VA Yes
College: Christopher Newport University, Newport News, VA Yes Bechelor or Science In Business Adminstration
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I am Invested In the town's continued success and thoughtful growth, I bring a collaborative approach, strong judgement and a willingness Io learn,
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of 3/20/13
Town of Mansfield
n II((I'!(I1
Application to Serve on a Board, Commission, I �''; l i ; ` F ! C F
Committee or Study Group ROO J tli (> 'Al
Name: hMaaelsea Datelrs2s
I'
i
Addr,,,- 1980ak SVee;
Telephone No. (Rome) mn,
E-Mail Address: m%rhaelsoa35�ejmWl.wm
(Cell) 774-719,8047
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Conunitteest
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Aceess Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Dthcl.: 6kyde 8 Patlestnan NNxn k Plarngy Cmmillteo
Historical Commission
industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII scholarship ru nd Committee
Zoning Board oi'Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. &cyds 8 PedUsWan Nebva k Po m4 Commidee B.
3. Wliy do you want to serve on this pardeular Board, Committee, or Commission"?
tm pmbd to boa roadoUt a! Mensfietd termer hvemy-rivayoars.l baGas®thatayW have Ilro oRporhadt7la makalhAt9s Ifallaf amd Sm
are wasiin9 Maur Iknc. t have vrorked In heashcare aiN Wblc habkh im mast ai mY career seed epprapate the baneiai ai providing opRorMtirres lorwaislrryl trails,
bane pelt and meals at eaerneava farms of lwnsporlatan, rm a recreational As, and use many of iha wakii,g Indite in MaftfW rabeWOy.I serve w various
boards and amnm1ltlees for professional and state w9snizatons, and 1nsl2uaona 1 have teamed a b, at" the way Sad teel Ke t tan canlKmate
4. Please state three attributes you can bring to this Board, Committee, or Commission.
II Tho aCaTy to wom Independently and waaobotively. To serve os a lease, a, a member of a group to 8oneb2 depred w1oomt(s).
2111n a reweabonal biker and avid welkerhaker and Understand the➢opodanee of etaalnvost0o, heaelMwarid atoassada means al aVm'hetlw lmnspxdat .
31 epn anindeA+ess and %%agness 10 UNe,
5. How you attended any meetings orthis Board, Committee, or Commission? (Optional)
1 have taltetdw aarinrs town Meetings m the pest.I WOW loom operalleos dosly by reading his papa,, 1A.Ing the lawn wabsbe.
6. Are there any changes you would like to make if you are appointed to this Board,
Conmlittec, or Commission?
This Is a new mmngam. I wood have to see how a isstn Lead, rondlons. what 4 is lasked wAh achhohng and mmm4tee Members redreishifte.
7. What is your availability? blights? Weckcnds?
rm ReWir and tw,k hem home most of the tune. I Naval hall a dozen time a year prdassmnnlly and 3-5 hews a year patemaay, Nights are best.
8. Do you regularly attend Town Meeting? Yes -EL No ' I
9. Have you ever served on a Board. Committee, or Commission in the Town of Mansfield?
Yes-1_.No r l
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A, Dates:
B. Dates:
H. Please list your present employer:
(Optional)
Employer: Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee of
Commission.
I have worked h beablreans(itie mletabo5c health,co;potate7ccm,Mee:cai haadh) by over leanly five years. )satire an BC,D td Board he Diabetes
and Educal'ron (CBDCE). I chdY roMimYleec fd Messociarsetl Diabetes Net" oWatad in mrr,,meboh with Mass DPN, Assoeialion Of cishetrecom A
Educarmn Sp cizBals (ADCES), and Amedean D'abelea Assodabm (ADA). Pin a ttadmbatad isme a Protassimb+,
11 Education Background:
Name and Location Graduated Degrec(s)
(Yes or No)
High School: OrmlldcMahoo r Mo A. CT Yea
College: M,aaatla came Mariana, on Yes as. 9A
Other Secondary:UrcvelsityofRhode l:land soothW%stown,la Yea Ms
14. Picric list any professional affiliations (Optional):
Cedirxatam aouW for Dfabeles Card a Edreatro SP oleW. tCBDCE). American Diabetes Assodatioi (AMA MUOCIOW, M tkebalas Laid A ECedandn
S,Oahsils (ADCES), American Collage of Ldaslylo MedizI,m (ACLM), Assedadon of Cardioaaswlw and Poldronary Rehabmtalion tAAGVPR)
Is. Please list any other specialized interests and hobbies (Optional):
16, Please provide tiny additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
r
Sipnatutr:
Revised M21113 per BSO Vote of 3120114
4\NCI II
�t 'e Town of Mansfield i2 C t Jail
O-F ICE
Application to Serve on a Board, Commission,
Committee or Study Grb'ii� -!�_"='3 - FI: .30
Name:((-3F2T 1C Date
Addresser: __1 77 �i.-� S'r-
Telephone No. (Home) , i �. �f� (Cell) V 9—" —) 7 J G—#O
C-Mail Address: ;?,JAN SA UP:r OV gfin z'om
I. Are you a registered voter in Mansfield? Yes No _
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. �t5'Tw?lcA� (ma�9M. B.
3. jhy dorwarfo eon this particular Board, Cc;;Feeo�ission
t t 7-) 'j� ryz
4. Please state three attributes you can bring to this Board, Committee, or Commission.
('.UR-A-v-_t2- TE, srAG
j`1t_(,oe-o,rS A-a'a_- oil bw� l vtr Nisi��
S. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
11 V -1 HA7-- I /--,&A nZ,,�n �
7. What is your availability? Nights? Weekends?
Oat �deAtn a 9 �dVk-
8.
9.
Do you regularly attend Town Meeting? Yes _V No
Have you ever served on a Board, Committee, or Commission i�t-the Town of Mansfield?
Yes r/ No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. K10- &-�> a�WLk Aa Dates: /t GG / reA
B. CAkP,TM /il&nrc✓ (
11. Please list your present employer:
(Optional)
Employer: rqo4l
Position:
Dates: CCU / f� eAt
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: q;-) ukc4 t+--Lv✓1 t1 C '7
College: �,GE7! l o U/i k% `/"A 914—
Other Secondary
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of nny ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per nSO Vote of 3/20/13
;E:CEI`'FD
F
Town of Mansfield
WF
Application to Servo on a Board, CommAU16
Committee or Study Group
Name: `r Ojai 1 OP4i, Date 11 SI atQL
Address: A 7 14N %( rr pe i ve MA4,1 He L U �
Telephone No. (Home) 5 01 - 261-03a1 (Cell) 1*7 d0'
E-Mail Address:
Are you a registered voter in Mansfield? Yes. No_�
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Qmnoil
Finance Committee
Board of Health
other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your tNw choices in order of preNrence:
A. Oaad #F Arsejfo a B,
3.
to serve on
or Commission?
4. Please state three attributes you can bring to this Board, Committee, or Commission.
1
S. I love you attended any meetings of this Board, Committee, or Commission? (Optional)
No
6. Are there any changes you would like to make if you are appointed to this Hoard,
Committee, or Commission?
NIA 44 -AU
7. What is youravailability? Nights? Weekends?
Wlele do t r r4A~ -NiGa
8. Do you regularly attend Town Meeting? Yes No
9. 1live you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes No
M Ifyou answered "yes' above, please list the Bonnls, Committees, and/or Commissions you have
served on:
A,
B,
Datcs:
It. Please list your present employer:
(Optional)
Bmpinyor. Position: �^
-_WL�ui{ SCwtR4 Cfvt Ghft�' _�'&.v1«c O FiGQ%Ic
M Please list any skills or spueft lined knowledge you can bring to this Board, Committee or
Commission.
e
13, Education Background:
High School:
Name and Location (Irgdpated
`�, e/sJor No)
�L1� filw�
College: UNr✓. /F ffIr��t���Ttf pr 'Attl+-
Other Secondary:
14, Please list
Degree(s)
15, Please list any other specialized interests and hobbles (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
` ioog--) wN A4,Mbt.- Sw4cf 2B00
__ilr•e.� ur TAW—*—, i--_
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
kvlsed 321/13 per BSO Vote or3120113
Signature
RECEIVED
ioWtj CLERKS OFFICE
0 Town of Mansfield ���
� ��� � �= i0ib IJAY 14 P 12: 04
e �a�+r Application to Serve on a Board, CommissionVIANSFiELD
Committee or Study Group PiP. �\Clit JQ, F T T S
Name: Kaiflyn Malkin
Southpark Ln Mansfield MA 02046
Telephone No, (Home) 508.811a857
E-Mall Address: kaitlynmalkin@gmail.wm
14,2026
(Cell) 5N-817-7857
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Planning Board
3. Wiry do you want to serve on this particular Board, Committee, or Commission?
I am Interested In joining the Planning Board to wniribute to the town and become more knowledgeable about land use and real estate stale and local laws and
how they are applied. As a lifelong Mansfield resident and recent home owner, I am invested In the town and hope to help shape the future of the town's housing
Infrastructure, and environmental preservation. As a former representative to the TOD wmmittea about 5 years ago for the local cultural council, I found the
process In deciding appropriate land use within zoning and goals for the town was very Interesting and rewording.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
I believe three attributes I could bring to the Planning Board Is being fair and open-minded to differing Interests, able to obtain operagonmi knowledge quickly, and
am a conscientious worker. I am a lawyer by trade and bellove that through this background I have been able to understand how to Interpret laws and have an
open-minded ougwk on differing Interests that I can be fair in evaluating without letting personal Interests affect my ougook. I am a very organized person and
believe it Is Important to be present, be prepared, and be responsive to requests and attendance in meetings.
S. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
Outside of being on a former TOB zone discussion group that curtained some members. I've never attended meetings of Its Board.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I'd like to explore furthering the enforcement of histodcallyEesignated roads and ensuring responsible development that acknowledges and addresses the
effects on the environment for conservation.
7. What is your availability? Nights? Weekends?
I am generally free most weeknlghts except Thursdays, and could occasionally be available on weakens as headed.
8. Do you regularly attend Town Meeting? Yes Z No 1_
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Iv l
Yes I - No _F-1
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A Local Cultural Council
19
Dates: W017-4f2020
Dates:
it. Please list your present employer:
(Optional)
Employer: Position:
Verrill Employee Benefits and Executive Compensation
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
I took courses In law school on State and Local Government and Property Law, winch addressed zoning and land use, as well as general legal principles on
property law common law. I belleve that I can gain a general understanding of applicable state and local laws that apply to the operations of the Planning Board
quickly.
13. Education Background:
High School
Name and Location Graduated Degree(s)
(Yes or No)
Mansfield High School, Mansfield MA Yes High Schad Diploma
College: Univemityof Massachusetts Amhefsl,Amherst MA Yes Bachelors of Arts In Political Science and Legal Studies
Other Secondary: Northeastern University School of Law, Boston MA Yes Jude Doctor
14. Please list any professional affiliations (Optional):
American Hof Association
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I am willing and able to regularly attend bi-monthly meetings and have the ability to review documents and proposals in preparation between meetings.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
f1ffw,l-t' ��e't Z.4,/.
Signature
Revised 3121/13 per BSO Vote of 3/20/13
Town of Mansfield WNI!
Application to Serve on a Board, ComifflM�o
,-0,2
Committee or Study Group
Name: Eric Greenberg Date 1.25.16
395 Central St Mansfield MA 02028
Telephone No. (Home)
E-Mail Address: gmenberg.erimoi®gmall.com
(Cell) 508.446.5230
1. Are you a registered voter in Mansfield? Yes , No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: Bicycle & Pedestrian Network Plan Committee
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. Bicycle BPedestrian Network Plan Committee B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I am a frequent walker and biycle rider in the town of Mansfield
4. Please state three attributes you can bring to this Board, Committee, or Commission.
Positive attitude, Open to hearing other Ideas, able to change my mind when presaged with other options, consume building
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
7. What is your availability? Nights? Weekends?
Nights generally work best with the exception of the 3rd Tuesday of the each month
8. Do you regularly attend Town Meeting? Yes 1:1 No _u-
9. Have you ever served on a Board, Connnittee, or Commission in the Town of Mansfield?
Yes = No FV-1__
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
r:11
n
Dates:
Dates:
11. Please list your present employer:
(Optional)
Employer: Position:
Norton Public Schools Paraprofessional
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Ipswich High school Ipswich MA r
College: wesfieid state college westiold AAA V BA History
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
Disc Golf
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21/13 per BSO Vole of 3/20/13
ecaxar si I t a . }: }
Town of Mansfield
e,9.es Application to Serve on a m Boardd � si
Committee or Study GroCqup' �� ��
I r,
Nance: Cynthia Deltano Date03/23/26
Address: 166 Stearns Avenue
Telephone No. (Home)
C-Mail Address: cdeitano®vedzon.net
(Cell) 508-369-4035
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Connnittees:
Airport Commission
Animal Welfare Conunittee
Board of Assessors
Cable Access Board of Directors
Conservation Conunission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: Town Manager Screening Committee
Historical Commission
Industrial Development Conunission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. N/A B. N/A
3. Why do you want to serve on this particular Board, Committee, or Commission?
mmroaeootaaw:ovr.:wn�•.,aw.�aa.rw.,�m.,m,wmem.wnreew^a;mo.:wr�nv.�..a% � er we:.n..a;m w.xreV upeowam.:sw..m�a;wnam.wua»ro.�.�w,.�.naa:n
4. Please state three attributes you can bring to this Board, Conuninee, or Commission.
Honesty; Collaborative and Ethical.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
N/A
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
N/A
7. What is your availability? Nights? Weekends?
1 am available nights and some day time hours.
8. Do you regularly attend Town Meeting? Yes El No Z
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes = No _EL
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. NIA Dates:
B. NIA Dates:
H. Please list your present employer:
(Optional)
Employer: Position:
Retired from the EOPS and Department of Correction
12: Please list any skills or specialized knowledge you can bring to this Board, Committee of -
Commission.
Experience In Interviewing and hlring; able to discern and able to communicate effectively.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High SC11001: Randolph High School Yes
College: Northeastern
Yes 1983 BS In Criminal Justice
Other Secondary:
14. Please list any professional affiliations (Optional):
N/A
15. Please list any other specialized interests and hobbies (Optional):
N/A
16. Please provide any additional information you feel may be helpful while reviewing your
application.
N/A
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3121/13 per HSO Vote of 3/20/13
Town of Mansfield lil (
Application to Serve on a Board, Commission, oBi►>tl� ittee or
tl �(
i J
Study Group ;� ;: I I
Name:✓IB�n Cosa Date��o�?G (ic
Address: & w is
a/ Ll
a- M
4 S-td/Cz
Telephone No. (Home)
6O8'
)& /- ?P
$ (Cell) hG,r �? 60,5'
E-Mail Address: (awaCt Ad
1. Are you a registered voter in Mansfield? Yes ✓ No
Town Boards, Commissions, Committees:
Airport Commission Historical Commission
Animal Welfare Committee Industrial Development Commission
Board of Assessors Library Trustees
Cable Access Board of Directors Municipal Building Committee
Conservation Commission Planning Board
Council on Aging Recreation Commission
Cultural Council WWII Scholarship Fund Committee Finance Committee
Zoning Board of Appeals
Board of Health Keep Mansfield Beautiful Committee
Other:
2. Please mark your two choices in order of preference:
A. �I SIB/ GO I t (I/��1 ��� B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
/d r
4. Please state three attributes you can bring to this Board, Committee, or Commission.
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
/�
cdr�n Ce.� s/eru D�
6. Are there any changes you would like to make if you are appointed to this Board,
Committee. or Commission?
7. What is your availability? Nights? Weekends?
8. Do you regularly attend Town Meeting? Yes V No
9. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes No
to. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. ),Q A 61mro / a.. ('1121L Dates: 1�6 GAS
B. �y{(p � �Otiin�_t� Dates: llta!4(C� 1;wZg wl'7
it. Please list your present employer:
(Optional)
Employer: Position`L:
�� C � A15/lC- 7fGG l
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: &!04 Gzn tvw�N 5
College:
iI
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of Interest'
provided by the Town Clerk, if appointed, and to the best of my ability agree to abide by
the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of320/13
' Town of Mansfield �l E'lii 0
e,. s Application to Serve on a Board, Commission,
Committee or Study Group 202u hifsll ?`,� ;� b: 10
KeA cr i O
Name: v owey Date
9 concern ends
Telephone No. (Home)
G-Mail Address: keIbmmehy1023®yahoo.wrn
(Cell) 617469-3231
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other: 9oard of Regiatrare
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A, aoardot Registrars B.
3, Why do you want to serve on this particular Board, Committee, or Commission?
1 would like to continue serving on this board because I believe in playing an active role to ensure felt and transparent elections In our town.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
I will continue to bring critical thinking, good judgment and professionalism to the board.
5. Have you. attended any meetings of this Board, Committee, or Commission? (Optional)
member.
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I do not have any recommendallons for changes at this time.
7. What is your availability? Nights? Weekends?
As needed
8. Do you regularly attend Town Meeting? Yes 21 l_. No __ _
9.. Have you ever served on a Board, Committee, or Commission in the Town of Mansfield?
Yes,( No _F-1
10, If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Boardof Reglsimrs
Dates: W20124-3131/26
B. Dates:
11. Please list your present employer:
(Optional)
Employer: Position:
Michael J. MacDougall Electrician Business Adminisiretor
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
I will Continue to bring string commpnlcatton, administragve and management skills to the board.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Ma-hfieW High SOW, Marshfield MA yes Diploma
College: tdeuamaccmm,Ntyc-*e
Am W aloe o�. b eoauaea Maaaeama.n
Other Secondary:
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I am a detatWented person with store; problemsoldng skids who works well independently and as part of a team. I look forward to thu opportunity to
Continue seeing on the boaru In order W suppott fair and tmnspsront elections for our tam.
1 will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signatur
Revised 3121/13 par DSO Vote of 3120/13
ap<<mv r
Town of Mansfield
='!CE
Application to Serve on a Board, Co >s�gjo>u�,
Committee or Study Group I"'i ��`
I [l
Name: Mary Chappuis Date January 16, 2026
109 South Main Street #4
Telephone No. (Horne) 508-873-8982
E-Mail Address: Mchapp4840@gmail.com
(Cell) 508-873-8981
Are you a registered voter in Mansfield? Yes X No
Town Boards, Commissions, Committees:
Airport Conunission
Animal Welfare Conrnittee
Board of Assessors
Cable Access Board of Directors
Conservation Conarnission
Council on Aging
Cultural Council
Firrance Conmrittee
Board of Health
Other: eicyde&PedeelnanN~rk Plan Commitlee
Historical Conuuission
Industrial Development Conmussion
Library Tmstees
Municipal Building Conunittee
Planning Board
Recreation Conunission
WWII Scholarship Fund Conunittee
Zoning Board of Appeals
Keep Mansfield Beautif 11 Conunittee
2. Please nark your two choices in order of preference:
A.
In
3. Why do )von want to serve on this particular Board, Conunittee, or Conmrission?
I have lived in Mansfield for 30+ years, I have used the town's streets as a pedestrian
walking to school as a middle school student, later as a runner training for road races
and now as a dog owner, all three of these perspectives give me a strong understanding of pedestrian needs.
I. Please state three attributes you can bring to this Board, Conunittee, or Commission.
I think the long term local perspective, who has walked, biked and run the streets of Mansfield.
I think I can offer fresh and practical Insight seeing as a dog owner I have a new lens on safely,
usability. I have a collaborative mindset, listening and working with a group to help keep
Mansfield a beautiful place to walk and ride.
5. Have you attended any meetings of this Board, Committee, or Corrunission? (Optional)
I have attended Board meetings in the past, but not
6. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
I would love to see lighting improved in areas that have high traffic areas.
7. What is your availability? Nights? Weekends?
I am available night and weekends! I am not available on Tuesdays.
8. Do you regularly attend Town Meeting? Yes _0_ No ✓�
9. Have you ever served on a Board, Conmrittee, or Conunission in the Town of Mansfield?
Yes = No 51 1_
10, If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
0
to
Dates:
Dates:
11. Please list your present employer:
(Optional)
Employer: Position:
MassCPAS Executive Operations Specialist
12: Please fist any skills or specialized knowledge you can bring to this Board, Committee or
Conmussion.
I bring my personal experience walkinglbiking/running the streets of Mansfield.
I bring strong communication skills, attention to detail, and community
focused approached to problem solving. I am able to listen carefully and share Ideas
while working respectfully with other to find a practical solution.
13. Education Background:
Name and Location Graduated
(Yes or No)
High School: Mansfield High School, Mansfield, MA. Class of 1995.
College: Katherine Gibbs School, Boston
Other Secondary:
1997 Bachelor of Science in Secretarial Arts
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
Degree(s)
I6. Please provide any additional information you feel may be helpful while reviewing your
application.
I am a proud resident of Mansfield my sisters and I grew up riding our bikes from
one side of Mansfield to the other. I love walking the town and want the same for
my nieces who are just starting to move around a little Independently.
I would like to help make sure the Mansfield I walked is the same for them.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3121/13 per BSO vote of 3/20/13
Name:
Telephone No. (Home)
Town of Mansfield OWNRE COVED FF ICE
Application to Serve on a Board, CoiUgilrt, Wilk P I; 59
Committee or Study Grouptu�b i�
Date
(Cell)
E-Mail Address: d Pt h(00ch6fG ei 0UYk1C-vfoot
Are you a registered voter in Mansfield? Yes V No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board o Healt r�
Other: W rOT14,' al t tl td
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A. 001— PV'iif 1 A' B.
4. Please state three attributes you can bring to this Board,
6.
13. Education Background:
High School:
Col
Other Secondary:
Name and Location Graduated Degree(s)
(Yes or No)
09
�WFOAJ-�
14. Please list any professional fBliations (Opllona ):
ti e 9�i a 4 nmli�_
(Q.S
15. Please list any other specialized interests and hobbies (Optional):
/ 'irlod . wi)c�,if . (2f)Y ortnr,ia.c j )4;jOP,
16. Please provide any additional information you feel may be helpful wbile reviewing vour
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Si n tur
Revised 3/21/13 per BSO Vote of 3/20/13
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
G. Are there any changes you would like to make if you are appointed to this Board,
Committee, or Commission?
7. What is your availability? Nights? Weekends?
1 ffri C I,uolICA.0, tea
8. Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Commission in the Town of nsfield?
Yes = No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A. Dates:
B. Dates:
11. Please list your present employer:
(Optional)
Employer: Position:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission.
3✓ ( tIeays (IS a-P,00hci41 0 M 0 C��fi1160(:e ncar 5(z V6- 11`�
eM)IYciS_
RECEIVED
I OVi H CLERKS OFFICE
Town of Mansfield
t916 ,IUI. --2 P 12: 03
Application to Serve on a Board, Co"m. iss ,
Committee or Study GrV.hp •�i i,D
, iC��l aCTTS
Name:Date
Telephone No. (Home) (Cell)
`�c��t�2k,�o�E-Mail Address: )(Y\
Are you a registered voter in Mansfield? Yes \ No
Town Boards, Commissions, Committees:
Air of Cotmnissiion-------_--
Animal Welfare Committee_
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
Woi Qt e B.
( C}( {lM tq +ce
M
4. Please state three attributes you can bring to this Board, Committee, or Commission.
R
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
6. Are there any changes you would like to make i f you are appointed to this Board,
Committee, or Commission?
8. Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Commission in the �- n sfield?
Yes _ No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A,
!?a
i 1. Please list your present employer:
(Optional)
Dates:
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Committee or
Commission. -
z
M
13. Education Background:
Name and Location G duated Degree(s)
Yes r No)
High School:
College:
Other Secondary:
14. Please list any professional affiliations (Optional):
is. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Revised 3/21113 per BSO Vole of 3/20/13
Signature
Q(.1N01 l
k ='o Town of Mansfield )� (• i', �)
s ' Application to Serve on a Board, Commission, �
Committee or Study Group �
Name: b4C)/Ak y:.�1✓le�.. �rASN Date 7�' 26
Address: S Co K; n,)v
Telephone No. (Home) /�7_Y� S 2-1 5- (Cell) So\-..e , 0-S�—
E-Mail Address:
1. Are you a registered voter in Mansfield? Yes V No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Coimnission
Industrial Development Commission
Library Trustees
Municipal Building Commniuce
Planning Board
Recreation Commission
WWII Scholarship Fund Cuunittee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order orpreference:
A.���nr: B.
3. Why do you want to serve on this particular Board, Committee, or
4. Please state three attributes you can bring to this Board, Committee, or Commission,
5. Have you attended any meetings of this Board, Committee, or Commission? (Optional)
I 1 . t i
6. Are there any changes you would like to make if you are appointed to dtis Board,
Committee, or Commission?
7. What is your availability? Nights? Weekends?
8. Do you regularly attend Town Meeting? Yes No
9. Have you ever served on a Board, Committee, or Conunission in the Town of M sfieId?
Yes = No
10. If you answered "yes" above, please list the Boards, Committees, and/or Commissions you have
served on:
A.
10
it. Please list your present employer:
(Optional)
Dates:
Dates:
12: Please list any skills or specialized knowledge you can bring to this Board, Cotmnittee or
Conunission.
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School:
College: Col oJc U A;Vt,(ii4Vj Hn i 1 ,111 NY
JJJ
Other Secondary:
14. Please list any professional affiliations
15. Please list any other specialized interests and bobbies (Optional):
16, Please provide any additional information you feel may be helpful while reviewing your
application,
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
4ignature
Revised 3/21/13 per BSO Vote or 3/20/13
Town of Mansfield F I!'F()
F I['E
~'A A4A Cp Application to Serve on a Boarommission,
Committee or Study GrM i' J { i %Q F) 3: ? 3
Name: K IM a a� Date
Address:
Telephone No. (Home) (cell)
E-Mail Address: 1 ' AN S i5I Et_1)MAi7 ES, AV PO^ (V_")A1 i_.o Q'rq
1. Are you a registered voter t" n Mansfield? Yes V No
Town Boards, Commissions, Committees:
Airport Comi�sion
Historical Commission
Animal Welfare Committee
Industrial Development Commission
Board of Assessors
Library Trustees
Cable Access Board of Directors
Municipal Building Cmmnittee
Conservation Commission
Planning Board
Council on Aging
Recreation Commission
Cultural Council
WWII Scholarship Fund Committee
Finance Committee
Zoning Board of Appeals
Board of Health
Keep Mansfield Beautiful Committee
Other: I CYC,L% 4- �
tr
/vr,7iA/oAK
2. Pleas mark your two r ices in order of preference:
�a
3. Why do you want to serve on this particular Board, Committee, or Commission?
4. Please state three attributes you can
n
to this Board, Committee, or Commission.
I -r4i poolic 7caC2
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: MXgVgl( LA105 SGIlW tI W (,5T W2 W
College: i_ o Ldfaf Or
1)'K. 00 CY efts
19 9 /
SA
C. oUiyla.3
Other Secondary: V M�4��
/ o �C(-L
I 9 /
/ ' r S
�D/'J(0
�Ir(" &dI," ' `tl'ec�
14. Please list any professional affiliations (Optional):
is. Please list any other specialized interests and hobbies (Optional):
f A0 dux/ AVI12 !-¢Ilia + CYUtS_G
16. Please provide any additional information you feel may be helpful while reviewing your
application.
9 Ar ~1 VrrK(-Oa, 6 5V t:l r3,Ae (e
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest' provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
ignature
Revised 3121/13 per BSO Vote of 3/20/13
a Town of Mansfield
RECEIVED
Application to Serve on a Board,iC"ii'iWsFft OFFICE
Committee or Study Grolt % JUN 10 A 155
Name: Lisa Chaffee Date61912026 H/'`1 J{ IE1.D
lr,0,
Address: 545 Maple Street. Mansfield. MA
Telephone No. (Home) (Cell) 07-543-0951
E-Mail Address: Ilaachaffee545@gmail.com
Are you a registered voter in Mansfield? Yes x No
Town Boards, Commissions, Committees:
Airport Commission
Animal Welfare Committee
Board of Assessors
Cable Access Board of Directors
Conservation Commission
Council on Aging
Cultural Council
Finance Committee
Board of Health
Other:
Historical Commission
Industrial Development Commission
Library Trustees
Municipal Building Committee
Planning Board
Recreation Commission
WWII Scholarship Fund Committee
Zoning Board of Appeals
Keep Mansfield Beautiful Committee
2. Please mark your two choices in order of preference:
A Keep Mansfield Beautiful B.
3. Why do you want to serve on this particular Board, Committee, or Commission?
I have participated In numerous lawn cleanup days and I have volunteered to adopt my street for cleanup year round. I think It is
an incredibly important opportunity to engage with our community to encourage beautification of our shared space.
4. Please state three attributes you can bring to this Board, Committee, or Commission.
Active volunteer
Current member of Garden Club of Mansfield
Interested In suslalnability Issues
Eager to keep the community engaged with recognizing the power of a beautiful community space
13. Education Background:
Name and Location Graduated Degree(s)
(Yes or No)
High School: Needham High School Needham MA YES HS diploma
College: Hamilton College Clinton. NY YES BAin Sociology
Other Secondary: Boston Universily MBAconcentration In accounting
14. Please list any professional affiliations (Optional):
15. Please list any other specialized interests and hobbies (Optional):
16. Please provide any additional information you feel may be helpful while reviewing your
application.
I will read a copy of the Massachusetts General Laws Chapter 268A "Conflict of
Interest" provided by the Town Clerk, if appointed, and to the best of my ability agree to
abide by the provisions of the statute.
Signature
Revised 3/21/13 per BSO Vote of 3/20/13