Applications for City Boards, Commissions & Committees

Use this form to be considered for appointment to serve on the City's Boards/Commissions/Committees.  Applications will remain on file for one year.  Incumbents whose terms expire and who are eligible for reappointment will be contacted by the City Secretary concerning their desire for reappointment.

CONFLICT OF INTEREST:  Applicants should acknowledge any potential conflict of interest, to include current or past business contracts, relatives or relations who do business with the City, or any potential condition that may be construed as a conflict of interest.

INFORMATION PROVIDED ON THIS FORM IS SUBJECT TO RELEASE UNDER THE REQUIREMENTS OF THE TEXAS PUBLIC INFORMATION ACT.

APPLICANT'S NAME
DATE
ADDRESS WITH CITY STATE AND ZIP
CELL NUMBER
HOME PHONE NUMBER
EMAIL
CONFIRM EMAIL
HOW LONG HAVE YOU LIVED IN JERSEY VILLAGE?
OCCUPATION
EDUCATION (INCLUDE HIGH SCHOOL GRADE LEVEL IF YOUTH MEMBER)
COLLEGE OR PROFESSIONAL CERTIFICATES
LIST PROFESSIONAL AND/OR COMMUNITY ACTIVITIES
LIST ADDITIONAL PERTINENT INFORMATION/REFERENCES/GOLF EXPERIENCES
HAVE YOU SERVED ON A BOARD/COMMISSION/COMMITTEE IN THE PAST?
IF YES, LIST THE BOARDS/COMMISSIONS
ARE YOU AVAILABLE TO MEET DURING THE DAY?
SELECT THE BOARDS/COMMITTEES FOR WHICH YOU ARE INTERESTED IN SERVING









LIST ANY ADDITIONAL COMMENTS
SIGNATURE OF APPLICANT: By typing your name in the field below, you agree to be considered for appointment to the Boards/Commissions/Committees that you have selected on this application.