Application for Boards & Commissions - City of Saugatuck

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Application for Boards & Commissions

SECTION A - CONTACT INFORMATION

* Indicates required field

Name *

First

Last

Email *

Home Phone Number *

Mobile Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

SECTION B - EMPLOYMENT INFORMATION

Current Employer *

Occupation/Position *

Business Phone Number *

Business Reference Name *

First

Last

[object Object]

Business Reference Phone Number *

Business Reference Email *

Does your employer have any business dealings wth the City which might present a conflict of interest *

Yes No

If yes, please explain: *

SECTION C - ADDITIONAL INFORMATION

Are you a City of Saugatuck resident? *

Yes No

Are you a registered City of Saugatuck voter? *

Yes No

Serving on a board or commission can be time-consuming. Are you committed to attending all regularly scheduled meetings? *

Yes No

On which boards and/or commissions would you be willing to serve? *

Board of Review Fire District Board Historic District Commission Interurban Board Kalamazoo Lake Harbor Authority Kalamazoo Lake Sewer and Water Authority Board Library Board Parks and Public Works Committee Planning Commission Tri-Community Non-Motorized Trail Study Committee Tri-Community Wildlife Committee Zoning Board of Appeals Compensation Commission

Please describe any qualifications, expertise or special interests that relate to your possible appointment: *

Cover Letter *

Max file size: 20MB

Resume *

Max file size: 20MB

SECTION D - DIGITAL SIGNATURE

The City of Saugatuck recognizes and supports the concept of a balanced representation in regard to filling vacancies on Boards and Commissions. To this end, every effort is made to appoint members who represent Saugatuck's diverse community, including citizens of all ethnic groups as well as people with disabilities. Reasonable accommodations and equal access to communication are provided upon request.

Digital Signature *

First

Last

**Disclaimer: Per the City of Saugatuck's retention schedule this application will be kept on file for twelve months, unless you are chosen to serve on a board, then this application is kept on file for the duration of your term.

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Saugatuck, MI 49453
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Home
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Links
Contact