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2. The City of Denison seeks residents interested in public service by serving on the City's boards and commissions. Some boards require special qualifications and all require a commitment of the volunteer's time. The volunteer must also have an unselfish desire to serve our community.
4. Name of Board or Commission
5. Staff Representative
7. The following nominee is to be considered for

   1. Appointment
   2. Reappointment
8. At the City Council Meeting on:
10. If reappointment, number of years Nominee served previously on this board or commission?
11. What was the nominee's attendance rate at meetings of the board in the most recent year of membership?
13. Nominee Information
15. Volunteer's Name
16. Physical Address
18. Mailing Address
19. Email Address
21. Nominee Lives Within the City Limits

    1. Yes
    2. No

    (For Civil Service Commission - within three (3) years)

23. Home Phone Number

    (Home)

24. Work Phone Number
26. Occupation
27. Employed by
29. Business Address
31. Are you currently or have you recently served on any other board or commission within in three (3) years?

    1. Yes
    2. No
33. If yes, what board and last year served?
35. Qualifications for Appointment to This Board or Commission
37. Additional Information About Yourself Which May Be Useful to the Council in Considering Appointment: (Education, Experience, Special Areas of Interest, Leadership Graduate Etc., )
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field