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2. Select the Board, Commission, or Committee applying for*
   -- Select One --Arts CommissionBoard of AdjustmentBuilding Code of AppealsChildren's Memorial Fund Advisory BoardCycling and Pedestrian Task ForceDiversity and Inclusion CommissionEnergy and Sustainability Task ForceHistoric Preservation CommissionParks & Recreation BoardPlanning & Zoning CommissionTax Increment Financing (TIF) CommissionTraffic CommissionTree BoardWarrensburg Convention & Visitors Bureau
4. Personal Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Home Phone Number*
19. Email Address
21. Residency Information
23. Length of Residency in Warrensburg (or surrounding area)*
25. Organization Membership Information
27. Are you currently serving on other Boards, Commissions, or Committees?*

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

    1. Yes
    2. No
33. If yes, list all
35. Do you have any relatives who work for the City of Warrensburg? Are you employed with the City?

    1. Yes
    2. No
37. If yes to the above questions, provide the relatives' names and relationships or if employed, the department in which you work.
39. Why are you interested in serving on a Board for the City of Warrensburg?
41. What is your knowledge of the advisory Board/Commission you're applying for?
43. List any experience or skills you have that qualify you for this position.
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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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