nom form by 96Y9RIn

VIEWS: 0 PAGES: 1

									                                             NEW HAMPSHIRE RIVERS MANAGEMENT AND PROTECTION PROGRAM

                        LOCAL RIVER MANAGEMENT ADVISORY COMMITTEE NOMINATION FORM

Please Note: In an effort to reduce our use of paper, as well as the amount of time expended by local officials on nomination paperwork,
the Rivers Management and Protection Program has made the nomination process electronic.
Please download and complete this form, then submit it to the Rivers Coordinator at: riversprogram@des.nh.gov, and please type
“NOMINATION FORM” followed by your name in the subject line of the email. Thank you!

NOMINEE NAME:                       MUNICIPALITY:                         RIVER NAME:                                    DATE:

Interest(s) Nominee Represents: (please check all that apply)

  Local Government           Business        Conservation         Recreation        Agriculture        Riparian Landowners

Contact Information:

Street Address:
Town:
Zip Code:
Email:

Phone (home):

Phone (cell):

Phone (work):

Board of Selectmen or Authorized Signature(s) - REQUIRE
       Name:                                                                       Title:
       Name:                                                                       Title:
       Name:                                                                       Title:


        Note: By statute, the Commissioner of DES appoints the Local River Management Advisory Committee (LAC) members for each Designated River
        from nominees submitted by the local governing bodies through which the Designated River flows (RSA 483:8-a).

        *For more information about Local River Management Advisory Committees please go to: http://des.nh.gov/organization/divisions/water/wmb/rivers/lac/index.htm
        *For more information about Designated Rivers, please go to: http://des.nh.gov/organization/divisions/water/wmb/rivers/desigriv.htm

								
To top