EP 1110-3-8
9 Apr 04
APPENDIX D
SAMPLE RAB COMMUNITY INTEREST FORMAT
Community Interest
(Name of FUDS Property) Restoration Advisory Board (RAB)
RAB members are volunteering to serve a 1-to 2-year term and to attend all RAB meetings.
Duties and responsibilities will include reviewing and commenting on technical documents and
activities associated with the Defense Environmental Restoration Program at (name of FUDS
property). Technical experts will be made available to the RAB. Members will be expected to
be available to community members and groups in order to facilitate the exchange of information
and/or concerns between the community and the RAB. RAB community members can expect to
devote approximately (number of hours/days) per year to the RAB. RAB members will receive
no compensation for their service.
Priority for RAB membership will be given to local residents who are impacted/affected by
the (name of FUDS property).
Name: ______________________________________
Address: _____________________________________________________
Street
Apt #
City
State
Zip
Phone: (
)
(
)
(
)_________
Daytime
Home
Fax
1. Are you affiliated with any group related to environmental restoration activities? If yes, list
the group and your position, if applicable.
2. Briefly state why you would like to participate on the RAB.
3. What experience have you had working as a member of a diverse group with common goals?
4. The community co-chairperson will be selected by community members of the RAB. Please
indicate whether or not you are interested in being considered for the community co-chairperson
position on the RAB.
Yes, I would like to be considered.
______No, I would not like to be considered.
D-1
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