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Citizen Advisory Boards & Committees Application Form

  1. Please check the boards / committees you are interested in:*
  2. Personal Information
  3. Residency Information
  4. Are you a registered voter*
  5. Education, Profession and Hobbies
  6. Organization Membership Information
  7. Are you currently serving on other Boards, Commissions, or Committees?*
  8. Have you served on a Board, Commission, or Committee before?*
  9. (Civic organizations, PTO, etc.)
  10. Acknowledgment*
    I understand that in accordance with Florida Sunshine Law, the above information is considered a public record.

    I understand that appointment to any of the positions listed above is a voluntary service and is not compensated.

    I understand that an appointment to any of the above boards or committees subjects me to the Florida Sunshine Law.

    If appointed, I agree to faithfully perform the duties of my office, make every endeavor to serve my foil term, and will comply with all laws or ordinances of the City, County and State of Florida, particularly those pertaining to the conduct of public office and the financial disclosure requirements, if applicable to my position.
  11. To electronically sign this form, please type your name in the field above and use a forward slash ( / ) before and after your name. Example: /FirstName LastName/
  12. Leave This Blank:

  13. This field is not part of the form submission.