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Fe <br />Qq - l5 <br />opt-c,S-q9 <br />INFORMATION REQUESTED ON BOARDS/COMMISSIONS APPLICATION (1 I5-0 <br />Name: <br />Home Address/Zip Code: <br />Council District: <br />Home Phone: <br />Work Phone: <br />Are you registered to vote at your current address? <br />I AM INTERESTED IN SERVING ON: <br />_ Board of Zoning Adjustments <br />_ Human Resources Commission <br />Planning Commission <br />Youth Advisory Commission <br />Employment or Volunteer Experience: <br />Related Education or Training: <br />_ Library -Historical Commission <br />_ Personnel Relations Board <br />_ Recreation & Parks Commission <br />I want to serve on this Board or Commission because: <br />*Have you ever been convicted (or is trial pending) of any violation of the law, excluding <br />minor traffic violations? <br />*Have you been cited for violating any city ordinances within the last 12 months? If so, <br />explain. <br />Optional References: (May list up to three) <br />*The information provided will not prohibit you from being considered for appointment <br />to a Board or Commission. <br />