APPLICATION FOR MEMBERSHIP:
(Fillable Form OR Print Form and Hand Print Responses – Attach Resume if Desired)
NAME: _____________________________________________ DATE:
ADDRESS: HOME PHONE:
CITY/ZIP: WORK PHONE:
EMAIL ADDRESS: CELL PHONE:
Are you a City resident? If yes, how long?
Are you a registered voter?
For Civil Service Commission ONLY: Political Affiliation:
(Required per LSMC §2.68.020 C: At the time of appointment, not more than two civil service commissioners shall
be adherents of the same party.)
NAME/ADDRESS OF EMPLOYER (and type of business):
EDUCATIONAL BACKGROUND (including year graduated and degrees):
PROFESSIONAL EXPERIENCE:
ORGANIZED AFFILIATIONS:
WHY ARE YOU SEEKING APPOINTMENT?
WHAT QUALITIES DO YOU POSSESS THAT WOULD ENABLE YOU TO FULFILL THE POSITION?
Signature
Please return completed application to:
City of Lake Stevens
Attn: Deputy City Clerk
1812 Main Street, P.O. Box 257
Lake Stevens, WA 98258
OR: deputyclerk@lakestevenswa.gov
425.334.1012
Board/Commission Being Applied For
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