Board and Commission Application
May 02, 2018
submission
#47
Application Form
Applicant Information
Title | --- |
Name | --- |
Home Address | --- |
What is your length of residence in Monrovia? Please indicate years and months. | --- |
Cell Phone | --- |
--- | |
Employer | --- |
Occupation | --- |
Business Address | --- |
Educational Background - Please describe any degrees obtained, licenses or special certificates held. | --- |
Please list any organizations to which you belong (such as Professional, Technical, Civic, etc.). | --- |
How did you learn about the Board and Commission vacancies? | --- |
If Other, please describe. | --- |
Board and Commission Information
Please check all of the boards or commissions to which you are interested in applying. | Community Services Commission |
Are you currently or have you ever been a member of any City board or commission? | Yes. |
If yes, please list which one(s) and indicate the start and end dates of service. | --- |
Why do you wish to serve, or continue to serve, on a board or commission? Why do you believe you are qualified to serve? | --- |
What experience or special knowledge do you have pertaining to your area(s) of interest to serve? | --- |
If selected, do you have adequate time available to serve? | --- |
Resume (Optional) | --- |
Certification
Certification - Please read before signing.
Do you agree to the above statement? | --- |
City Review
Internal Review
Application Received | --- |