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Government » Support Services » City Clerk

General Online Boards Application

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Download this Application as a PDF

Please correct the fields below:

Please correct the field(s) marked in red below:

I wish to be of service to our Community and request your consideration for appointment to:

Name of Board, Commission or Committee (submit one declaration for each)

Your Information

Your Information

Name

Address

City

State

Zip Code

Primary Phoneext.

Secondary Phoneext.

Email Address

Employer/Occupation

What community activities have you participated in during the past five years?

Are you a resident of the City of Walla Walla?

Yes (How Long?) If other, type text here.

Are you a registered voter of the County of Walla Walla?

Yes

Are you serving, or have you served, on any citizen boards or commissions? If yes, list the organizations and dates of service.

Are you serving, or have you served, on any citizen boards or commissions? If yes, list the organizations and dates of service.

Organization

Date(s) of Service

Organization

Date(s) of Service

Organization

Date(s) of Service

Additional Information

Additional Information

Please provide a brief background sketch including job experience, education, skills, hobbies, and special areas of interest.

What problems, issues or concerns do you see facing this particular board or commission, and how would you propose they be addressed?

What special skills, knowledge, or experience do you have to contribute to this particular board, committee, or commission?

What limitations, if any, are placed on the time you would be available for meetings and other activities? How much time are you able to devote to the duties of this board, committee or commission?

References

References

Reference #1 Name

Reference #1 Address

Reference #1 Phoneext.

Reference #2 Name

Reference #2 Address

Reference #2 Phoneext.

Reference #3 Name

Reference #3 Address

Reference #3 Phoneext.

To assist us with our communication and marketing efforts, please indicate how you learned of this vacancy: