The City of Hartford welcomes your interest in serving on a board or commission. To apply, first complete this form. Then,
email this Profile Form, your resume or a brief biography, and the Required Narrative (described below) to . You will receive an email response when we receive the three required documents.
Name: __________________________________________________________________________________________
First M.I. Last
Home Address:
Work Address:
Mailing Address if different _______________________
Email Address: _________________________________
Company: ________________________________________
Title: ____________________________________________
Email Address: ___________________________________
Phone #s:
Are you currently a registered voter? Yes No If yes, in what city/town? __________________________
Are you registered with a political party? Yes No
If yes, list your political affiliation, e.g. Democrat, Green, etc.: ___________________________________
Are you currently serving on a Hartford Board or Commission? Yes No
If yes, please list name(s) of Board(s)/Commission(s): ______________________________________________________
Organizational Memberships and/or Professional Affiliations: ____________________________________________
Individual Interests: Select the Board(s) and/or Commission(s) in which you are interested:
Golf Course Oversight Commission
Commission on Grandparents Raising
Historic Properties Commission
Commission on HIV/AIDS
Commission on Homelessness
Commission on Housing
Hartford Housing Authority Board of
Commission on Human Relations
Human Resources Appeal Board
Internal Audit Commission
Commission on Lesbian, Gay, Bisexual
and Transgender Issues
Hartford Parking Authority Board of
Commission on Veterans Affairs
Parks and Recreation Advisory
Pension Commission
Planning and Zoning Commission
Board of Preservation Appeals
Hartford Redevelopment Agency
School Building Committee
Greater Hartford Transit District
Board of Directors
Metropolitan District Commission
Board of Commissioners
Permanent Commission on the Status
of Hartford Women
Tree Advisory Commission
Zoning Board of Appeals
Commission on Refugee and
Immigrant Affairs
Required Narrative: Please write a narrative explaining why you want to serve or continue to serve on the Board(s) or
Commission(s) you have chosen above. If you have a first choice, please indicate. Describe the skills and experience you
possess that are relevant to the board or commission you chose. Further, describe your involvement in the Hartford
community and how it relates to service on a board or commission. Add any additional information you wish.
Certification: I _______________________hereby certify that all information on this form and in my two attachments is
true and accurate to the best of my knowledge. _____________________
Date Rev. 8.1.17