1 | Page
CITY OF HELENA APPOINTMENT APPLICATION
You may fill out this form digitally and return via email, by clicking "fill & sign" in the .pdf toolbar.
Please complete this form and return it to the following address:
City Clerk’s Office, City of Helena, 316 N. Park Avenue, Room 323,
Helena, Montana, 59623
Unless otherwise stated, you must be a city resident in order to participate on a City of
Helena advisory board/committee. To see a map of the Helena City limits, go the following
link: https://www.lccountymt.gov/fileadmin/user_upload/GIS/CompPlanMaps/PDF/Getting-
Around/CityofHelena2020StreetsandTrails36x48NOINDEX.pdf
Name: Date:
Address: Phone:
Email Address:
(w)
I am applying for appointment to:
(PLEASE INDICATE THE BOARD/COMMITTEE AND IF APPLICABLE, THE SPECIAL DESIGNATION OF THE
APPOINTMENT; i.e. joint appointment, student leader, health care professional, etc.)
Board/Committee: Special appointment (if applicable):
Please write a brief statement explaining why you would like to serve on the Board(s)
named above.
Experience:
Organizations/Affiliations:
Education:
Work Experience:
