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Volunteer Application Return to: 101 N. 4th Street / P.O. Box 1030 Douglas, WY 82633 [PHONE REDACTED], Fax: [PHONE REDACTED] Volunteer Application Page 1 of 2 I:\COMDOC\City Clerk\Boards & Commissions\Applications, Forms, Misc Docs & Lists\20220722 Application for Boards and Commissions.doc Name of Applicant: Address: City/State/Zip: Mailing Address (if different from above): Home Phone: Cell Phone: Work Phone: Email: 1. Are you a resident of the City of Douglas? Yes No 2. I am interested in serving on the following Boards/Commissions (Please all that apply): Boards/Commissions/Committees: Douglas Planning & Zoning Commission/Board of Adjustments Historic Preservation Commission Converse County Tourism Promotion Board Douglas Housing Authority Board Federal Urban Systems Advisory Committee Douglas Board of Appeals Steering Committee Member (when applicable) Focus Group Member (when applicable) Recycling Task Force Other: 3. Have you served on any of these Boards/Commissions previously? Yes No 4. If “Yes”, please indicate which Boards/Commissions and when you served: 5. In what community/communities did you previously serve? 6. In what position(s) would you be willing to serve? (Please select all that apply.) Chairperson Vice Chairperson ---PAGE BREAK--- Volunteer Application Return to: 101 N. 4th Street / P.O. Box 1030 Douglas, WY 82633 [PHONE REDACTED], Fax: [PHONE REDACTED] Volunteer Application Page 2 of 2 I:\COMDOC\City Clerk\Boards & Commissions\Applications, Forms, Misc Docs & Lists\20220722 Application for Boards and Commissions.doc Secretary Treasurer Board, Commission, or Committee member only 7. Do you understand the attendance requirements as provided per Douglas Municipal Code and/or the Bylaws of the Board or Commission you wish to serve on? Yes No 8. If “No”, please provide a description of your question(s): 9. Why are you seeking this appointment(s)? Signature of Applicant Date For Office Use Only: Selected for: Length of Term/Dates: Additional Information: