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2. 
4. First Name*
5. Last Name*
7. Address1*
8. Address2
10. City*
11. State*
12. Zip*
14. Telephone 1*
15. Telephone 2
16. Email Address*
18. The following questions are optional:
20. Are you a resident of Chelmsford

    1. Yes
    2. No
21. Do you or have you served on an elected or appointed town Board or Committee

    1. Yes
    2. No
22. If Yes, please explain
24. Is this input/recommendation from an official town Board or Committee

    1. Yes
    2. No
25. Which Board or Committee?

27. Proposed Recommendation to the Town Charter

    The Chelmsford Town Charter is available at http://ecode360.com/CH1747 or at the Town Clerks Office
29. What section number of the Charter does your change affect?*
31. Proposed recommendation:*
33. Brief description of the issue addressed by the proposed change:*

35. Impact of Proposed Change
37. What benefits will be realized by the citizens and/or government of Chelmsford?*
39. What potential impacts may be associated with the proposal change?*
41. Can you provide data to assist in validating the impact of the proposed change?*
43. Describe any obstacles, costs, or cost savings associated with the proposed change:*
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45. 1. Receive an email copy of this form.
46. Email address

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47. Submit

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