Online Application for Board/Commission Appointment
|
Date: |
12/05/2019 |
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: |
|
|