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City Council Application - Vacancies Page 1 of 1 CITY OF DOUGLAS City Council Vacancy Application Name of Applicant: Address: City/State/Zip: Mailing Address (if different from above): Resident in the State of Wyoming Since: Date of Birth: Occupation: Home Phone: Cell Phone: Work Phone: Email: 1. Are you a resident of the City of Douglas? Yes No 2. Are you a registered voter in Converse County? Yes No Any person seeking appointment to the Douglas City Council must be a registered voter and resident of the City of Douglas. Please provide a detailed account of why you are seeking this position on Douglas City Council, including experience, qualifications, and a commitment to attend at least two meetings per month in addition to occasional Work Sessions, Special Meetings, and service on other boards and commissions as a Council Member. Feel free to use an additional sheet(s) of paper if necessary. Signature of Applicant Date FOR OFFICE USE ONLY Selected for Office: Term of Office: