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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:
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