Fillable CITY OF YAKIMA BOARDS AND COMMISSIONS APPLICATION (City of Yakima)

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CITY OF YAKIMA BOARDS AND COMMISSIONS APPLICATION (City of Yakima)

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STDC Brds&CmmApplication.doc -- - 4.21.21
CITY OF YAKIMA
BOARDS AND COMMISSIONS
APPLICATION
We appreciate your interest in serving your City in this capacity. We ask you to complete this brief form to help
provide the City Council with sufficient information to make an appointment to the desired board or commission
of the City of Yakima.
A. Please Print Clearly:
NAME: (Mr., Mrs., Ms.)
HOME ADDRESS:
Number Street Apt. City Zip Code
PHONE NUMBERS:
Home Business Other (Specify)
E-MAIL: FAX:
YAKIMA RESIDENT: YES NO If Yes, number of years
B. Please number the board(s), commission(s) or committee(s), etc. in the priority in which you are
interested.
Arts Commission *
Yakima Historic Preservation Commission *
Bike/Pedestrian Committee
Housing Authority Board *
Board of Appeals
Parks and Recreation Commission
Charter City Employees Civil Service Commission
Parks and Recreation Commission Youth Position
Community Integration Committee
Police and Fire Civil Service Commission
Community Integration Committee Youth Position
Public Facilities District Board
DYBID Advisory Committee
Yakima Planning Commission *
Henry Beauchamp Jr. Community Center Advisory Board
OTHER:
*Additional information requested for representation requirements:
Arts Commission and Yakima Historic Preservation Commission: Please complete supplemental form
Yakima Planning Commission and Yakima Housing Authority: Please provide a resume along with the application
C. Available for day meetings: Available for evening meetings:
D. Please give any training or experience that you possess which would be beneficial to a member of the board
or commission in which you are interested:
Continued on Page 2
STDC Brds&CmmApplication.doc -- - 4.21.21
E. Special reasons for wishing to serve on this Commission:
F. Have you ever served on any other board or commission? If so, please state city, state, dates, and name of
board or commission:
G. Please furnish two references who can speak to your qualifications for the desired appointment:
NAME:
ADDRESS:
Zip Code
DAYTIME PHONE NUMBER:
NAME:
ADDRESS:
Zip Code
DAYTIME PHONE NUMBER:
H. Please be advised, ESB #5964 effective July 1, 2014 mandates persons filling certain state and local
government offices and positions, including board and commission appointments, complete training
regarding the Open Public Records Act within 90 days of election or appointment.
---------------------------------------------------------------------------------------------------------------------------------------
When a vacancy occurs on a board or commission in which you have indicated an interest, your application will
be provided to the Council Committee. The Committee will then make a recommendation to Council for
appointment. The Council Committee or the City Council may desire to conduct an interview.
As an applicant for the above position for the City of Yakima, I hereby waive my right to privacy with
respect to the information contained in my application and any supporting documents attached
thereto. The City, its officials, or employees are authorized to make my application and supporting
documents available for public inspection, including inspection by members of the press and media.
Your Signature: Date:
---------------------------------------------------------------------------------------------------------------------------------------
Please return completed form to Yakima City Clerk, 129 North 2nd Street, Yakima, WA, 98901. Applications
will be kept on file for two years. (If you have any questions please call 575-6037.)
A brief description of the purpose of the boards, commissions and committees, etc. can be found on-line at
https://www.yakimawa.gov/council/boards-commissions/ under Boards and Commissions, or call for
information.
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CITY OF YAKIMA BOARDS AND COMMISSIONS APPLICATION (City of Yakima)

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Completed 20 February 2022

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