APPLICATION FOR CITY BOARD/COMMITTEE APPOINTMENT

Name:

___________________________________________________

Address:

___________________________________________________

 

___________________________________________________

Phone:

______________________________

E-mail:

______________________________

Fax:

______________________________

Date:

______________________________

Name of board/committee for which I wish to be recommended:

 

Professional Experience:

 

 

 

General qualifications for board service:

 

 

 

Why I am interested in this particular board, commission committee:

 

 

 

NOTE:
Please attach two letters of recommendation.
Application kept for three (3) years. You will need to re-apply to keep your application on file.