Application For Boards And Commission

I am interested in membership on the following boards and commissions:*
To select more than one item, hold down the "Ctrl" (control) key while you click on the individual boards or commissions of interest.

Nominated by:
Name of nominee:*
Home address:*
City:* State:* Zip:*
Phone number (Area Code):*
Council district you reside in:

Business/Company name:
Work address:
City: State: Zip:
Phone number (Area Code):
Fax number (Area Code):
E-mail: *
Preferred mailing address: Home Work
Occupation:*

Professional experience (include professional memberships and previous employment):

Community Activities (civic clubs, volunteer activities, service organizations, etc.):

Comments or special qualifications:

Previous service on city board/commission (please include dates of service):

Resumé (type or copy and paste your resume in the area below):

* Required fields

Optional:
Date of Birth:
Sex:
Ethnic Background:

Last Modified on 01/06/2014 13:31:34