Application for Appointment

2. Application for Appointment
   For volunteering to serve on a Board or Commission
4. Boards & Commissions*
   -- Select One --Affordable Housing CommissionArts CommissionBuilding Appeals BoardCable Television CommissionCivil Service CommissionDiversity, Equity, and InclusionEllensburg Business Development AuthorityEnvironmental CommissionLandmarks and Design CommissionLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionPublic Transit Advisory CommitteeSenior Citzens Advisory CommissionUtility Advisory Commission
6. Have you attended a meeting for the board or commission you are applying to?
   -- Select One --YesNo
8. Name of Applicant:*
10. Address*
12. Mailing Address (If Different)
14. City*
15. State*
16. Zip*
18. Email Address*
19. Phone Number*
21. Length of Residence in Ellensburg*
22. Do you live within the city limits?*

    1. Yes

    1. No
24. If applying for the Sr. Citzens' Advisory Board, are you at least 55 years of age?

    1. Yes

    1. No
26. Occupation Status and Background:*
28. Organization Affiliations:*
30. Why are you seeking appointment?*
32. Will you be able to attend meetings regularly if appointed?*

    1. Yes

    1. No
34. If your first choice, as listed above, is not available, which other boards or commissions would you be interested in serving on?
36. Boards & Commissions
    -- Select One --Affordable Housing CommissionArts CommissionBuilding Appeals BoardCivil Service CommissionEllensburg Business Development AuthorityEnvironmental CommissionLandmarks and Design CommissionLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionPublic Transit Advisory CommitteeSenior Citzens Advisory CommissionUtility Advisory Commission
38. Boards & Commissions
    -- Select One --Affordable Housing CommissionArts CommissionBuilding Appeals BoardCivil Service CommissionEllensburg Business Development AuthorityEnvironmental CommissionLandmarks and Design CommissionLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionPublic Transit Advisory CommitteeSenior Citzens Advisory CommissionUtility Advisory Commission
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field