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Application for Board or Commission Vacancy

2. Eligibility Requirements
   - Board/Commissions that require 1-year residency<br>

   - Board/Commissions that require 1-year residency
   

4. Which board or commission would you like to be appointed to?

   1. Board of Adjustment
   2. Community Activities Commission

   1. Parks Advisory Board
   2. Planning Commission

   1. Wellington Housing Authority
   2. Board of Trustees

6. Name

8. Address

10. City

11. State

12. Zip Code

14. Home Phone Number

15. Work Phone Number

17. Cell Phone Number

18. Email Address

20. Wellington Resident (Number of Years/Months)

21. Current Occupation

23. Please list any relevant education, employment, or volunteer experience you have.

25. Are you currently serving on any other board or commission?

    1. Yes

    1. No

27. Have you attended a meeting of the board or commission you are applying to?

    1. Yes

    1. No

29. Why do you want to become a member of this particular board or commission?

31. What do you believe are the 3 most important issues that this board or commission have now or will have in the next few years?

33. Please specify any activities you are involved in that may create a conflict of interest should you be appointed to this board or commission.

35. Signature
    Upon application for and acceptance of appointment, board and/or commission members demonstrate their intention and ability to attend meetings. If appointed, frequent non-attendance may result in termination of appointment.<br><br> I hereby declare, that if appointed, I will accept the appointment assigned to me by the Town of Wellington Board of Trustees.<br><br> By signing below, I swear and/or affirm that to the best of my knowledge, the information I have provided in this application is true and correct.

    Upon application for and acceptance of appointment, board and/or commission members demonstrate their intention and ability to attend meetings. If appointed, frequent non-attendance may result in termination of appointment.
    
    I hereby declare, that if appointed, I will accept the appointment assigned to me by the Town of Wellington Board of Trustees.
    
    By signing below, I swear and/or affirm that to the best of my knowledge, the information I have provided in this application is true and correct.

37. Signature of Applicant

38. Date
    Date

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

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