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 Citizen Volunteer Form Citizen Volunteer Form (Note: You must be a registered voter to be eligible to serve on a City Board or Commission) Name ________________________________________________________ Home Phone __________________ Work Phone ___________________ Address ______________________________________________________ Education_____________________________________________________ Occupation____________________________________________________ I would like to be considered and could devote sufficient time to serve on the following Board(s), in order of preference: 1. ___________________________________________________________ 2. ___________________________________________________________ Please list any prior experience serving on any public boards and approximate dates. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Please list any other experience that may be pertinent to the board that you are requesting to serve on. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ I understand that appointment to a City of Buchanan Board or Commission requires attendance at all board meetings. Members will be automatically dismissed upon occurrence of the third consecutive absence. Date ______________ Signature __________________________________ If you have questions, please call 695-3844 May 2003 |
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