Consideration of Board Appointment
Application Type * Name of Board or Committee * -- Select One -- Beautification Advisory Committee Building Board of Adjustments and Appeals City Council Economic Improvement Corporation Food Service Advisory Board Golf Advisory Board Kerr Central Appraisal District Library Advisory Board Main Street Advisory Board Parks Advisory Board Planning and Zoning Recovery Community Coalition Reuse Water Ad Hoc Advisory Committee (RWAC) Zoning Board of Adjustments Zoning Ordinance Input Committee Title * Full Name * Home Address 1 * Home Address 2 * Mailing Address 1 Mailing Address 2 Home Phone * Home Fax Business Phone Business Fax Cell Phone Email Address * Are you a qualified voter in the city of Kerrville? * Do you live inside the city limits of Kerrville? * How Long? Employer Employer Address 1 Employer Address 2 Employer City Employer State Employer Zip Occupation To the best of your knowledge, are you employed by, or a member of, any entity (business or non-profit) with proposals, programs, requests, businesses, applications, licenses or any other matters which may come before a board or commission for review, funding, support or approval during the next two years? * If yes, please list the name of entity and interest * List most advanced degree received School degree received from Year Volunteer Experience/Community Service Please specify membership on any other governmental board/commission/committee Interest Type If selected, please list other interest Recovery Community Coalition Applicants Only - Select Applicable Stakeholder Group You Represent Have you ever been a member of a board or commission? * If yes, please specify (board/commission and dates of service) * Have you attended a board or commission meeting in the past 12 months? If yes, please specify Do you have any comments about your experience while serving? In your opinion, what are the three most pressing issues facing your prospective board or commission? Describe ways in which you have contributed to your community What do you hope to accomplish by serving? Based on your relevant skills and interests, in which of the following areas do you think you can contribute most? If Other, please specify Please list current and past civic, fraternal and non-profit organizations in which you are/have been active
(Please list Organization Name, Dates and any Title held)
Please provide any additional information you believe would be useful in considering your application I am not employed by the City of Kerrville.
If appointed, I will notify the City of Kerrville of any changes in my residence or business, or of any other relevant changes that would affect my appointment. I will also notify the City if any potential conflicts of interest arise
I recognize that my appointment requires my regular attendance and participation at all scheduled meetings. Failure to do so may result in my removal. I am willing to make this commitment of time and effort.
I understand and acknowledge that by selecting the 'I Agree' option below, I hereby certify that all information in this application is complete, truthful and accurate to the best of my knowledge.
Leave This Blank: