City of Anaheim - City of Anaheim Application for Appointment to Boards and Commissions

City of Anaheim Application for Appointment to Boards and Commissions

You may apply using the online form below or click here to download a printable application.

NOTE: Gray fields are optional.

Application for Appointment

APPLICATION
NAME:
PHONE
MAILING ADDRESS
BUSINESS PHONE
ARE YOU A RESIDENT OF THE CITY OF ANAHEIM?	Yes No
ARE YOU ELIGIBLE TO VOTE?	Yes No
HAVE YOU PREVIOUSLY SERVED ON A CITY BOARD OR COMMISSION?	Yes No
IF YES, WHICH ONE(S) AND DATES:
ARE YOU A PAID EMPLOYEE OF THE CITY OF ANAHEIM:	Yes No
IF YES, GIVE POSITION AND WORK LOCATION:
EDUCATIONAL BACKGROUND: Remaining Characters:
WHAT ARE THE QUALIFICATIONS/STRENGTHS OR EXPERIENCE RELEVANT TO THE BOARD OR COMMISSION DESIRED? Remaining Characters:
You may use this field to enter additional information you may find useful in reviewing your application (i.e.; resume, personal objectives). INSTRUCTIONS: Please use a text editor (i.e.; Notepad) before pasting any information into this field. After you have edited your text, copy and paste it into the field. Please do not use a word processor (i.e.; MS Word, Wordpad, Word Perfect) to copy text from into this field. If your text is not copied from a text editor, undesired text may appear on your submitted application. Therefore, please proofread all text before submitting this form. Remaining Characters:
REASONS YOU ARE INTERESTED IN SERVING ON THIS BOARD: Remaining Characters:

Supplemental Information

Please check one: I authorize the City of Anaheim and its officers and employees to release the information set forth on this page to the public upon request. I request the City of Anaheim and its officers and employees to maintain the confidentiality of the information set forth on this page to the extent permitted by law. ** If requesting confidentality, please provide contact information that can be released to organizations requesting copies of rosters for purposes of business (i.e. invitations). I request full confidentiality
ADDRESS		TELEPHONE
CELL PHONE		E-MAIL ADDRESS

Digital Signature

By submitting this form, this serves as my online signature	"I understand that Members of this Board/Commission must be residents (qualified electors) of the City of Anaheim and not hold any paid office or employment with the City of Anaheim."
Signature Date
I have read this and understand the previous statement.	Yes