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91 E Central Avenue Belgrade MT 59714 City of Belgrade Phone:[PHONE REDACTED] Fax: [PHONE REDACTED] APPLICATION FOR APPOINTMENT Name: Street Address: Mailing Address: City, State, Zip: E-Mail Address: Work Phone: Home Phone: Applying to Advisory Board or City Council as shown below: Appointed City Council Member, Ward___(variable term) Gallatin Local Water Quality Board (3 yr term ) Board of Adjustment (3 yr term) Gallatin Solid Waste District (3 yr term ) City/County Library Board of Trustees (3 yr term ) Belgrade Police Commission (3 yr term ) City/County Planning Board (2 yr term ) Belgrade Senior Center Advisory Board (3 yr term) City Impact Fee Advisory Committee (2 yr term ) Streamline Advisory Board (2 yr term ) City Park and Recreation Board (3 yr term ) Other Please summarize and describe your interest and qualifications for the position(s) you wish to be considered for: References: Name and Phone number: Name and Phone number: Name and Phone number: * Signature of Applicant: Date: Completed applications may be submitted by regular mail, email or fax: Belgrade City Clerk 91 E. Central Avenue Fax: [PHONE REDACTED] Email: [EMAIL REDACTED] Rev: 01/2023 Belgrade MT 59714