Revised May 2020
Boards and Committees
Application for Reappointment
(Voluntary Position)
NOTE: This application is only for those who are seeking reappointment to a
board or committee on which they presently serve. If you are not presently
serving on a board or committee, please complete the Application for Initial
Pursuant to Chapter 119, Florida Statutes, this application and any related
written or electronic communication shall become a public record and is
subject to public disclosure.
1. Name ______________________________________________
Last First Middle
2. Current board/committee _______________________________
3. Date appointed to current board/committee ________________
4. Home Address: ________________________________________
Phone ____________ Email _______________________________
5. Is all of the information that you provided in your initial application for
appointment (i.e., address, employment, etc.) accurate, current, and
complete? Y___ N____ If not, please use the box below to
describe any changes/corrections/updates to the information provided
in your initial application or any other information that may be relevant
to your application for re-appointment:
Revised May 2020
By my signature below, I affirm that all of the information provided in this
application is true and complete to the best of my knowledge:
Date Completed: ___________________
lease send your completed application via U.S. Mail, or fax:
Office of the City Clerk
Old City Hall
315 E. Kennedy Blvd., Third Floor
Tampa, FL 33602
Fax: (813) 274-8306
Date Received: _____________ Received by: _____________________
Transmitted to ______________________ on ________________.
Submit Application via Email
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