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Town of Old Lyme
Ethics Commission Application
Name:
Address:
Age: Sex: M/F (circle one)
Elector in Old Lyme: Y/N (circle one) Resident for ____ years
Employment history (brief):
Political Affiliation: D R I Other (circle one)
Community Involvement (brief):
Other relevant information:
________________________ ______________________
Signature Date
Please return by May 1, 2008 to Irene Carnell, Town Clerk, 52 Lyme St, Old Lyme, CT, 06371, or by fax to: 860-434-1400, or by email to jcollins@sswbgg.com
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