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2. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OneLibrary Board of TrusteesPlanning & Zoning CommissionBoard of AdjustmentsParks and Recreation Advisory Board
4. Personal Information
6. First Name*
7. Last Name*
9. Sex:*

   1. Male
   2. Female
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Home Phone Number*
21. Business Address*
23. Business Phone Number*
25. Occupation*
27. Email Address
29. Residency Information
31. Are you a registered voter*

    1. Yes
    2. No
33. Education and Hobbies
35. High School
37. College
39. Trade or Business School
41. Hobbies
43. Why are you interested in this Board or Commission?
45. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
47. If yes, which
49. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
51. If yes, which
53. Your experience beneficial to this Board of Commission
55. Other Civic Experience
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57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit Submit and Print

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