Name*

Address*

City*

State*

Zip Code*

Phone Number*

Email*

Board(s) Desired (List in Preferential Order) - (1) Parks & Recreation Advisory Board, (2) Land Planning Agency, (3) Pension Board, (4) Charter Advisory Board*

Employer

Position

Work Experience

Community Involvement

Interests / Activities

Why do you wish to serve on this/these board(s)?*

Resume or Additional Information can be Attached.

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

I understand the responsibilities associated with being a board member and I have adequate time to serve on this/these board(s).*

Yes

No