2. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OnePlanning & Zoning CommissionBoard of AdjustmentsBuilding and Standards CommissionRecycling CommitteeParks and Recreation Advisory BoardSenior Adult Services Advisory BoardAudit Finance CommitteeCitizen?s Advisory Task Force on Drainage
4. Personal Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Home Phone Number*
19. Business Address*
21. Business Phone Number*
23. Occupation*
25. Email Address
27. Residency Information
29. Length of Residency in City*
31. Are you a registered voter*

    1. Yes
    2. No
33. Education and Hobbies
35. High School
37. College
39. Trade or Business School
41. Hobbies
43. Organization Membership Information
45. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
47. If yes, which
49. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
51. If yes, which
53. Please list organization memberships and positions held
55. Please List Areas of Special Interest
57. Please Enter Basic Resume Information Below
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59. 1. Receive an email copy of this form.
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