Document Douglas_doc_46ab549bb0

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 Documents/Master Forms & Documents/City Boards & Application Forms/20230503 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)  Community Facility Task Force  Arts & Culture Board of Trustees  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? ---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 Documents/Master Forms & Documents/City Boards & Application Forms/20230503 Application for Boards and Commissions.doc 6. In what position(s) would you be willing to serve? (Please select all that apply.)  Chairperson  Vice Chairperson  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: SIGN