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2. Local Governing Body Leadership Program (LGLP) Application Form

   Please fill out the form below and attach copies of Certificates of Attendance.

   To be recognized in the current conference year, submissions must be made by September 1. Any submissions made after September 1 will be recognized at next year's Conference.

4. First and Last Name*
5. Title*
7. Municipality*
   -- Select One --Aberdeen TownshipAbsecon CityAlexandria TownshipAllamuchy TownshipAllendale BoroughAllenhurst BoroughAllentown BoroughAlloway TownshipAlpha BoroughAlpine BoroughAndover BoroughAndover TownshipAsbury Park CityAtlantic CityAtlantic Highlands BoroughAudubon BoroughAudubon Park BoroughAvalon BoroughAvon-By-The-Sea BoroughBarnegat Light BoroughBarnegat TownshipBarrington BoroughBass River TownshipBay Head BoroughBayonne CityBeach Haven BoroughBeachwood BoroughBedminster TownshipBelleville TownshipBellmawr BoroughBelmar BoroughBelvidere TownBergenfield BoroughBerkeley Heights TownshipBerkeley TownshipBerlin BoroughBerlin TownshipBernards TownshipBernardsville BoroughBethlehem TownshipBeverly CityBlairstown TownshipBloomfield TownshipBloomingdale BoroughBloomsbury BoroughBogota BoroughBoonton TownBoonton TownshipBordentown CityBordentown TownshipBound Brook BoroughBradley Beach BoroughBranchburg TownshipBranchville BoroughBrick TownshipBridgeton CityBridgewater TownshipBrielle BoroughBrigantine CityBrooklawn BoroughBuena BoroughBuena Vista TownshipBurlington CityBurlington TownshipButler BoroughByram TownshipCaldwell BoroughCalifon BoroughCamden CityCape May CityCape May Point BoroughCarlstadt BoroughCarneys Point TownshipCarteret BoroughCedar Grove TownshipChatham BoroughChatham TownshipCherry Hill TownshipChesilhurst BoroughChester BoroughChester TownshipChesterfield TownshipCinnaminson TownshipClark TownshipClayton BoroughClementon BoroughCliffside Park BoroughClifton CityClinton TownClinton TownshipCloster BoroughCollingswood BoroughColts Neck TownshipCommercial TownshipCorbin CityCranbury TownshipCranford TownshipCresskill BoroughDeal BoroughDeerfield TownshipDelanco TownshipDelaware TownshipDelran TownshipDemarest BoroughDennis TownshipDenville TownshipDeptford TownshipDover TownDowne TownshipDumont BoroughDunellen BoroughEagleswood TownshipEast Amwell TownshipEast Brunswick TownshipEast Greenwich TownshipEast Hanover TownshipEast Newark BoroughEast Orange CityEast Rutherford BoroughEast Windsor TownshipEastampton TownshipEatontown BoroughEdgewater BoroughEdgewater Park TownshipEdison TownshipEgg Harbor CityEgg Harbor TownshipElizabeth CityElk TownshipElmer BoroughElmwood Park BoroughElsinboro TownshipEmerson BoroughEnglewood CityEnglewood Cliffs BoroughEnglishtown BoroughEssex Fells BoroughEstell Manor CityEvesham TownshipEwing TownshipFair Haven BoroughFair Lawn BoroughFairfield TownshipFairview BoroughFanwood BoroughFar Hills BoroughFarmingdale BoroughFieldsboro BoroughFlemington BoroughFlorence TownshipFlorham Park BoroughFolsom BoroughFort Lee BoroughFrankford TownshipFranklin BoroughFranklin Lakes BoroughFranklin TownshipFredon TownshipFreehold BoroughFreehold TownshipFrelinghuysen TownshipFrenchtown BoroughGalloway TownshipGarfield CityGarwood BoroughGibbsboro BoroughGlassboro BoroughGlen Gardner BoroughGlen Ridge BoroughGlen Rock BoroughGloucester CityGloucester TownshipGreen Brook TownshipGreen TownshipGreenwich TownshipGuttenberg TownHackensack CityHackettstown TownHaddon Heights BoroughHaddon TownshipHaddonfield BoroughHainesport TownshipHaledon BoroughHamburg BoroughHamilton TownshipHammonton TownHampton BoroughHampton TownshipHanover TownshipHarding TownshipHardwick TownshipHardyston TownshipHarmony TownshipHarrington Park BoroughHarrison TownHarrison TownshipHarvey Cedars BoroughHasbrouck Heights BoroughHaworth BoroughHawthorne BoroughHazlet TownshipHelmetta BoroughHigh Bridge BoroughHighland Park BoroughHighlands BoroughHightstown BoroughHillsborough TownshipHillsdale BoroughHillside TownshipHi-Nella BoroughHoboken CityHo-Ho-Kus BoroughHolland TownshipHolmdel TownshipHopatcong BoroughHope TownshipHopewell BoroughHopewell TownshipHowell TownshipIndependence TownshipInterlaken BoroughIrvington TownshipIsland Heights BoroughJackson TownshipJamesburg BoroughJefferson TownshipJersey CityKeansburg BoroughKearny TownKenilworth BoroughKeyport BoroughKingwood TownshipKinnelon BoroughKnowlton TownshipLacey TownshipLafayette TownshipLake Como BoroughLakehurst BoroughLakewood TownshipLambertville CityLaurel Springs BoroughLavallette BoroughLawnside BoroughLawrence TownshipLebanon BoroughLebanon TownshipLeonia BoroughLiberty TownshipLincoln Park BoroughLinden CityLindenwold BoroughLinwood CityLittle Egg Harbor TownshipLittle Falls TownshipLittle Ferry BoroughLittle Silver BoroughLivingston TownshipLoch Arbour VillageLodi BoroughLogan TownshipLong Beach TownshipLong Branch CityLong Hill TownshipLongport BoroughLopatcong TownshipLower Alloways Creek TownshipLower TownshipLumberton TownshipLyndhurst TownshipMadison BoroughMagnolia BoroughMahwah TownshipManalapan TownshipManasquan BoroughManchester TownshipMannington TownshipMansfield TownshipMantoloking BoroughMantua TownshipManville BoroughMaple Shade TownshipMaplewood TownshipMargate CityMarlboro TownshipMatawan BoroughMaurice River TownshipMaywood BoroughMedford Lakes BoroughMedford TownshipMendham BoroughMendham TownshipMerchantville BoroughMetuchen BoroughMiddle TownshipMiddlesex BoroughMiddletown TownshipMidland Park BoroughMilford BoroughMillburn TownshipMillstone BoroughMillstone TownshipMilltown BoroughMillville CityMine Hill TownshipMonmouth Beach BoroughMonroe TownshipMontague TownshipMontclair TownshipMontgomery TownshipMontvale BoroughMontville TownshipMoonachie BoroughMoorestown TownshipMorris Plains BoroughMorris TownshipMorristown TownMount Arlington BoroughMount Ephraim BoroughMount Holly TownshipMount Laurel TownshipMount Olive TownshipMountain Lakes BoroughMountainside BoroughMullica TownshipNational Park BoroughNeptune City BoroughNeptune TownshipNetcong BoroughNew Brunswick CityNew Hanover TownshipNew Milford BoroughNew Providence BoroughNewark CityNewfield BoroughNewton TownNorth Arlington BoroughNorth Bergen TownshipNorth Brunswick TownshipNorth Caldwell BoroughNorth Haledon BoroughNorth Hanover TownshipNorth Plainfield BoroughNorth Wildwood CityNorthfield CityNorthvale BoroughNorwood BoroughNutley TownshipOakland BoroughOaklyn BoroughOcean CityOcean Gate BoroughOcean TownshipOceanport BoroughOgdensburg BoroughOld Bridge TownshipOld Tappan BoroughOldmans TownshipOradell BoroughOrange CityOxford TownshipPalisades Park BoroughPalmyra BoroughParamus BoroughPark Ridge BoroughParsippany-Troy Hills TownshipPassaic CityPaterson CityPaulsboro BoroughPeapack and Gladstone BoroughPemberton BoroughPemberton TownshipPennington BoroughPenns Grove BoroughPennsauken TownshipPennsville TownshipPequannock TownshipPerth Amboy CityPhillipsburg TownPilesgrove TownshipPine Beach BoroughPine Hill BoroughPine Valley BoroughPiscataway TownshipPitman BoroughPittsgrove TownshipPlainfield CityPlainsboro TownshipPleasantville CityPlumsted TownshipPohatcong TownshipPoint Pleasant Beach BoroughPoint Pleasant BoroughPompton Lakes BoroughPort Republic CityPrincetonProspect Park BoroughQuinton TownshipRahway CityRamsey BoroughRandolph TownshipRaritan BoroughRaritan TownshipReadington TownshipRed Bank BoroughRidgefield BoroughRidgefield Park VillageRidgewood VillageRingwood BoroughRiver Edge BoroughRiver Vale TownshipRiverdale BoroughRiverside TownshipRiverton BoroughRobbinsville TownshipRochelle Park TownshipRockaway BoroughRockaway TownshipRockleigh BoroughRocky Hill BoroughRoosevelt BoroughRoseland BoroughRoselle BoroughRoselle Park BoroughRoxbury TownshipRumson BoroughRunnemede BoroughRutherford BoroughSaddle Brook TownshipSaddle River BoroughSalem CitySandyston TownshipSayreville BoroughScotch Plains TownshipSea Bright BoroughSea Girt BoroughSea Isle CitySeaside Heights BoroughSeaside Park BoroughSecaucus TownShamong TownshipShiloh BoroughShip Bottom BoroughShrewsbury BoroughShrewsbury TownshipSomerdale BoroughSomers Point CitySomerville BoroughSouth Amboy CitySouth Bound Brook BoroughSouth Brunswick TownshipSouth Hackensack TownshipSouth Harrison TownshipSouth Orange Village TownshipSouth Plainfield BoroughSouth River BoroughSouth Toms River BoroughSouthampton TownshipSparta TownshipSpotswood BoroughSpring Lake BoroughSpring Lake Heights BoroughSpringfield TownshipStafford TownshipStanhope BoroughStillwater TownshipStockton BoroughStone Harbor BoroughStow Creek TownshipStratford BoroughSummit CitySurf City BoroughSussex BoroughSwedesboro BoroughTabernacle TownshipTavistock BoroughTeaneck TownshipTenafly BoroughTeterboro BoroughTewksbury TownshipTinton Falls BoroughToms River TownshipTotowa BoroughTrenton CityTuckerton BoroughUnion Beach BoroughUnion CityUnion TownshipUpper Deerfield TownshipUpper Freehold TownshipUpper Pittsgrove TownshipUpper Saddle River BoroughUpper TownshipVentnor CityVernon TownshipVerona TownshipVictory Gardens BoroughVineland CityVoorhees TownshipWaldwick BoroughWall TownshipWallington BoroughWalpack TownshipWanaque BoroughWantage TownshipWarren TownshipWashington BoroughWashington TownshipWatchung BoroughWaterford TownshipWayne TownshipWeehawken TownshipWenonah BoroughWest Amwell TownshipWest Caldwell TownshipWest Cape May BoroughWest Deptford TownshipWest Long Branch BoroughWest Milford TownshipWest New York TownWest Orange TownshipWest Wildwood BoroughWest Windsor TownshipWestampton TownshipWestfield TownWestville BoroughWestwood BoroughWeymouth TownshipWharton BoroughWhite TownshipWildwood CityWildwood Crest BoroughWillingboro TownshipWinfield TownshipWinslow TownshipWoodbine BoroughWoodbridge TownshipWoodbury CityWoodbury Heights BoroughWoodcliff Lake BoroughWoodland Park BoroughWoodland TownshipWoodlynne BoroughWood-Ridge BoroughWoodstown BoroughWoolwich TownshipWrightstown BoroughWyckoff Township
8. County*
   -- Select One --AtlanticBergenBurlingtonCamdenCape MayCumberlandEssexGloucesterHudsonHunterdonMercerMiddlesexMonmouthMorrisOceanPassaicSalemSomersetSussexUnionWarren
10. Address
12. City
13. State
14. Zip Code
16. Email*
17. Phone
19. Qualifying Programs Attended

    List all programs attended, including:

    • Program Title
    • Program Date
    • Points Earned

    For NJ Municipalities magazine articles, include the title and month that the article appeared in the magazine.

21. Program Title/Magazine Article 1
22. Program Date/Magazine Issue 1
23. Points Earned 1
25. Program Certificate 1
27. Program Title/Magazine Article 2
28. Program Date/Magazine Issue 2
29. Points Earned 2
31. Program Certificate 2
33. Program Title/Magazine Article 3
34. Program Date/Magazine Issue 3
35. Points Earned 3
37. Program Certificate 3
39. Program Title/Magazine Article 4
40. Program Date/Magazine Issue 4
41. Points Earned 4
43. Program Certificate 4
45. Program Title/Magazine Article 5
46. Program Date/Magazine Issue 5
47. Points Earned 5
49. Program Certificate 5
51. Program Title/Magazine Article 6
52. Program Date/Magazine Issue 6
53. Points Earned 6
55. Program Certificate 6
57. Program Title/Magazine Article 7
58. Program Date/Magazine Issue 7
59. Points Earned 7
61. Program Certificate 7
63. Leadership Level Achieved (check box):*

    1. Municipal Leader (25 points)
    2. Municipal Innovator (50 points)
    3. Municipal Pioneer (75 points)
64. Municipal Leader Certificate

    For the Municipal Innovator and Municipal Pioneer categories, attach a copy of your Municipal Leader Certificate.

66. Questions?

    Contact Danielle Holland Htut at 609-695-3481 x118 or email dholland@njlm.org.

Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

* indicates a required field