15535 Main Street NE • P.O. Box 1300 • Duvall, WA 98019 • (425) 788-1185 Fax 788-8097
www.duvallwa.gov
APPLICATION FOR BOARDS & COMMISSIONS
Name ______________________________ Date __________________________
Street Address ____________________________________________________________
Mailing Address (if different from above)
_________________________________________________________________________
_________________________________________________________________________
Phone # ______________________ Email ________________________________
Board or Commission for which you are applying_________________________________
Other Boards, Committees or Commissions on which you would be willing to serve:
_________________________________________________________________________
Current Occupation: ________________________ Employer: ______________________
1. Length of residence in Duvall ______________________________________________
Previous address if less than 1 year at current address:
_________________________________________________________________________
2. Reason you are interested in serving in this position:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. What community activities or other experience do you bring to this position?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. Do you have any special skills or expertise applicable to this position?
________________________________________________________________________
________________________________________________________________________
5. Educational/Occupational Background: _____________________________________
________________________________________________________________________
Are you available for evening meetings? ________ Daytime meetings? ______________
Are there any evenings or days that are unacceptable? _____________________________
Signature _________________________________________________________________
Return form to: City of Duvall, 15535 Main Street NE, PO Box 1300, Duvall, WA 98019
Or email to the City Clerk: jodi.wycoff@duvallwa.gov
THANK YOU FOR YOUR INTEREST IN SERVICE TO OUR COMMUNITY!
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