Crestview Board and Committee Application

2. 

4. City of Crestview
   General Application for all Boards and Committees of the City of Crestview

   General Application for all Boards and Committees of the City of Crestview

6. Name

7. Email Address

9. Address

11. City

12. State

13. Zip Code

15. Phone Number

16. Fax Number

18. City Resident?
    -- Select One --City ResidentI live outside the City but am interested in the City of Crestview

    Please advise if you are a Resident of the City of Crestview

20. City Boards and Committees

    1. Historic Preservation Board
    2. Planning and Development Board
    3. General Employee Retirement Board
    4. Police/Firefighters Retirement Board
    5. Citizens Advisory Committee (CDBG)

    Please select which board or committee in which you have interest. Please be advised that there may not be a current opening on the ones you select, but your applications will stay on file and you will be contacted should an opening occur.

22. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
24. Narrative

    Please give us a short narrative to let us know why you would be a good candidate for the City of Crestview Board or Committee

26. Electronic Signature

28. 

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field