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Boards and Commissions Application

2. Select the Board, Commission or Committee you wish to apply for*
   -- Select One --Airport Advisory BoardAirport Zoning BoardChildren's Fund BoardEconomic Development AuthorityHeritage Preservation CommissionHousing & Redevelopment AuthorityLibrary Advisory BoardPark & Recreation Advisory BoardPeter Smith Advisory BoardPlanning CommissionTommy Allen Youth Endowment FundTourism CommissionTree Board

   Before selecting your board, please visit http://www.ci.faribault.mn.us/253/Boards-Commissions to ensure that meeting schedule fits yours.

4. First Name*

5. Last Name*

7. Address1

9. Address2

11. City

12. State

13. Zip

15. Phone Number

16. Email

18. Occupation

20. List the day and hours you are available for meetings

22. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No

24. If yes, which one(s)?

26. Have you served on a Board, Commission or Committee before>

    1. Yes
    2. No

28. If yes, which one(s)?

30. Please list your reasons for your interest to serve on this board or commission

32. Please list your experience or expertise you can provide if appointed

34. Personal Reference 1

    Please list the individual's name and phone number.

36. Personal Reference 2

    Please list the individual's name and phone number.

Leave This Blank:


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

    This field is not part of the form submission.

40. Submit

* indicates a required field