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Online Application
for
Board/Commission Appointment
Date: 09/25/2017
Board/Commission Applying for:
Ward No.:
PERSONAL INFORMATION
First Name:
Last Name:
Home Address:
City:
Zip:
Email:
Home Phone:
Work Phone:
How Long in Aurora?
Are you registered to vote? Yes No
Date of Birth:
EDUCATION
Years Completed:
Degrees:
Colleges:
EMPLOYMENT
Employer Name:
Employer Address:
Position:
How Long?
Work Experience:
Certifications:
COMMUNITY INVOLVEMENT
Involvement:
Do you Presently Serve in Any Other Appointed Position on a Board, Commission or Committee? Yes No
If yes, what position:
Why do you desire this appointment?
How much time do you anticipate being able to spend on this appointment each month?
Interests/Activities:
PLEASE PROVIDE THREE REFERENCES
Name:
Address:
Phone:
Name:
Address:
Phone:
Name:
Address:
Phone:
STATISTICAL INFORMATION
The City of Aurora wishes to maintain certain statistical records on applicants for the volunteer boards, commissions and authorities. Please answer the questions below to assist us in compiling this data. The information you supply will be used only for statisical purposes. It will not be used in any way to discriminate against you because of your sex, race, age, creed, national origin, physical disability, or military status.THE INFORMATION REGARDING THIS SECTION IS STRICTLY VOLUNTARY AND WILL ONLY ASSIST THE CITY OF AURORA WITH STATISICAL COMPILATIONS.
How did you hear about us? Newspaper:
News Aurora(water bill newsletter)
Channel 8
Word of Mouth
Other:
By entering your initials, you certify that the foregoing information is true and correct.
Applicant Initials: