Revised June 2020
Boards and Committees
Application for Initial Appointment
Please read before completing application:
• If you are seeking reappointment to a board or committee on which
you are presently serving, please complete the Application for
Reappointment instead of this application.
• Pursuant to Chapter 119, Florida Statutes, this application and other
related written or electronic communication shall become a public
record and is subject to public disclosure.
• Completed applications will be kept on file for two (2) years from the
date received in the Office of the City Clerk.
• You may be required under Florida law to submit a Financial Disclosure
Form 1 (see wwww.ethics.state.fl.us).
• Appointment to a City of Tampa Board and/or Committee requires
compliance with the City of Tampa Ethics Code and Florida law
concerning appointed officials.
• All candidates selected for appointment may be subject to a criminal
• Many volunteer committees, boards, and commissions (whether at the
city, county, or state level) are classified as an ‘office’ under Florida
Statutes. The Florida Constitution prohibits anyone from holding more
than one such ‘office’ at the same time. Please verify with the City
Clerk if you are unsure as to whether the position to which you are
applying qualifies as an ‘office’ under Florida law.
1. Board/Committee of Interest: ___________________________
2. Name ______________________________________________
Last First Middle
3. Date of Birth ___________ Place of Birth __________________
4. Home Address ____________________________________________
Length of time at current address ___________________
Phone ____________ Email ____________________