Form Center

2. Application for which board or commission:*
   -- Select One --Design Review BoardArts Advisory BoardPark and Forestry BoardPlanning CommissionPublic Safety BoardLodging Tax Advisory Committee (LTAC)Human Services Advisory Board (HSAB)First Street Master Plan Advisory CommitteeEconomic Development Advisory Board (EDAB)
4. Name:*
6. Address:*
8. Home Phone:*
9. Cell:
11. Work Number:
12. Email:*
14. City Resident:

    1. Yes
    2. No
15. How long?
17. Urban Growth Area Resident:

    1. Yes
    2. No
18. How long?
20. Please list any previous City appointments or offices:
22. Other community affiliations or activities you feel would be a benefit to this position:
24. Why are you interested in serving on this board or commission?
26. What talents or experience would you bring to the position?
28. What are your primary interests in City Government and City Services?
30. Please relate any special goals you may have for the City:
32. Any other comments or information you wish to provide for Mayor and Council consideration:
34. Signature:*
36. Date:
38. Public Disclosure Act *

    1. I acknowledge

    Pursuant to the Washington Public Disclosure Act, (RCW 42.56), this form constitutes a public record and is subject to public release upon request. The following information may be redacted prior to disclosure pursuant to RCW 42.56.250(3): Residential addresses, residential telephone numbers, personal wireless telephone numbers, personal electronic mail addresses, social security numbers, driver’s license numbers, Identicard numbers, and emergency contact information of employees or volunteers of a public agency, and the names, dates of birth, residential addresses, residential telephone numbers, personal wireless telephone numbers, personal electronic mail addresses, social security numbers, and emergency contact information of dependents of employees or volunteers of a public agency.

Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field