2. I am interested in the following Board(s)/Commission(s):*

   1. Civil Service Commission
   2. Lodging Tax Advisory Committee
   3. Housing Authority

   1. Planning Commission
   2. Salary Commission
   3. Parks & Recreation Commission

   1. Arts Commission
   2. Municipal Airport Advisory Board

   1. Community and Economic Development Commission
   2. Climate Resilience Advisory Team
4. PERSONAL INFORMATION
6. First Name*
7. Last Name*
9. Telephone: Home/Cell*
10. Telephone: Work
12. Address1*
14. Address2
16. City*
17. State*
18. Zip*
20. Email*
21. Length of Residency*
23. Availability*

    1. Day

    1. Evening

    1. Anytime
25. PROFESSIONAL AND/OR PERSONAL REFERENCES
27. Name
28. Position
30. Phone Number
32. Address1
34. Address2
36. City
37. State
38. Zip
40. Name
41. Position
43. Phone Number
45. Address1
47. Address2
49. City
50. State
51. Zip
53. EDUCATION AND TRAINING COURSES
    List below past education and training courses, with the most current education listed first.
55. Institution
57. Dates Attended (Mo/Yr)
58. From:
59. To:
61. Course of Study
63. Degree
65. Institution
67. Dates Attended (Mo/Yr)
68. From:
69. To:
71. Course of Study
73. Degree
75. SUPPLEMENTAL QUESTIONS
    Please respond, in your own words, to the following questions.
77. 1. Why are you seeking appointment to this particular board or commission?*
79. 2. What special skills, knowledge, experience and/or talent do you have to contribute to this particular board or commission?*
81. 3. What community activities have you participated in during the past five years?*
83. 4. Please provide brief background information including job experience, hobbies and special areas of interest.*
85. 5. Have you previously served on one of our boards or commissions?*

    1. Yes
    2. No
89. Please attach OPMA training certificate.*

    Please complete the required Open Government Training Act, Lesson 3, and submit a signed copy of the training certificate

91. Please attach resume to this application.*

    A letter of interest is optional

93. Please be advised that this application or information in this application may be subject to disclosure to other governmental agencies, or to the public pursuant to request under the Public Disclosure Act (RCW 42.56).
Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit

* indicates a required field