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Name
Address
Preferred Role
To ensure ethical governance, please disclose any affiliations that may pose a conflict of interest.
Are you currently employed by Gloucester Township or any of its departments (e.g., Public Works, Sewer Utility, Fire Districts)
Are you currently employed by, contracted with, or affiliated with any pay-to-play vendor or firm doing business with Gloucester Township (e.g., planning, engineering, or redevelopment firms)?
Have you made political contributions to Gloucester Township officials or campaigns in the past 5 years?
Disclaimer Acknowledgment
I understand that all transition team roles are voluntary and advisory, with no compensation, jobs, or future employment promised or implied, in compliance with N.J.S.A. 19:44A-1 et seq. and N.J.S.A. 40A:9-22.1 et seq.
Conflict Disclaimer Acknowledgment
I agree to disclose any conflicts of interest and understand that, to ensure transparency, only my qualifications and proposed role may be publicly disclosed, while my personal information (e.g., name, email, phone number) will remain redacted and private in accordance with New Jersey privacy laws.
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