Individuals wishing to place items on the Agenda for a Meeting of the Board of Selectmen need to complete this form. Please include your name, phone number and a brief description of the topic to be considered and include any supporting material necessary to convey the intent and meaning of the topic/issue to be considered. All agenda request forms must be complete and submitted by noon on the Thursday preceding the Monday evening BoS meeting.

Date:

To:

From: Phone #

Re: