Instructions: Thank you for taking the time to fill out this application. Don’t hesitate to keep it brief, but please provide us the information that we need to understand who you are and why you would like to join the Pittsfield Listens Family And Community Engagement Group.

Please Note: Read the FACE Working Group Information Sheet prior to filling out this application. Application deadline is Friday January 27 at 5 pm. 

Please ensure that this application is filled out online (survey below), or visit Pittsfield Listens on Facebook for a copy to download and email (mobaxley@pittsfieldlistens.org), drop-off (74 Main St. at Pittsfield Community Center), or mail (P.O. Box 206 Pittsfield, NH 03263). For questions, contact Pittsfield Listens at info@pittsfieldlistens.org.

We will notify applicants in March about the FACE Working Group membership and convene an initial meeting soon thereafter. We look forward to reviewing all applications and are thrilled to continue this work with you for Family and Community Engagement with the Pittsfield School District!

Question Title

* 1. What is your first name?

Question Title

* 2. What is your last name?

Question Title

* 3. In what town do you live in?

Question Title

* 4. What is your gender?

Question Title

* 5. What is your age?

Question Title

* 6. List some of your community interests and/or involvement

Question Title

* 7. What is/are your connections to Pittsfield Schools (i.e. parent, PMHS alumni, family member of a student, volunteer)?

Question Title

* 8. Why are you interested in joining the FACE Working Group?

Question Title

* 9. What important skills and perspectives would you bring to the FACE Working Group?

Question Title

* 10. At what email address would you like to be contacted?

Question Title

* 11. What is the best phone number to reach you on? Please specify if call or text is preferred.

Question Title

* 12. Is there anything else you you’d like to share about your schedule and availability?

T