City of Abilene
Boards & Commissions Application
Your Information
FIRST LAST
LIVE WITHIN CITY LIMITS?
YES NO
HOME ADDRESS CITY STATE ZIP
NUMBER OF YEARS AS
AN ABILENE RESIDENT
MAILING ADDRESS CITY STATE ZIP
HOME PHONE
CELL PHONE
EMAIL ADDRESS
RETIRED?
YES
NO
OCCUPATION/FORMER OCCUPATION
BUSINESS ADDRESS
BUSINESS PHONE
EMPLOYER
VOTER REGISTRATION NUMBER or DATE OF BIRTH*
*Note: For specific boards, being a registered voter is required. The city can only verify through this through a voter registration number or date of birth.
Previous Experience on Boards, Commissions, or Other Civic Organizations
BOARD OR ORGANIZATION
CITY, STATE
YOUR ROLE
Please describe your education, professional affiliations, special knowledge, qualifications or expertise that relates to your possible
appointment (attach additional sheets if needed): ________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Please give a brief statement of why you would like to be appointed to a Board or Commission: ______________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
While there is no guarantee of an appointment, all applications will be considered equally. Applications will be kept on file for one
year and then either updated or withdrawn by the applicant. Please list the boards you are interested in serving:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Recognizing that serving on a Board or Commission is often time consuming and most meet on a monthly basis, are you committed to
attending all regularly scheduled meetings? YES I CAN TRY
I have attended one or more meetings of the board or commission for which I have applied.
YES NO
Applicant Signature _________________________________________________ Date ______________________________
FOR OFFICE USE ONLY
DATE APPLICATION RECEIVED: _____________________________________ NEW APPLICANT? YES NO REAPPOINTED
IF NO, APPLICANT PREVIOUSLY SERVED ON: ______________________________________________________________________________
APPLICANT APPOINTED TO: _____________________________________________________ TERM EXPIRES: ________________________
FULL TERM UNEXPIRED TERM ALTERNATE MEMBER EX-OFFICIO
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