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Boards and Committees Form
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First Name
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Last Name
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Organization Name (IF APPLICABLE)
Address1
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Address2
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Phone Number
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E-Mail Address
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In which City Council District do you reside?
City Council District
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District 1
District 2
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District 4
Partner Organization (Healthy West Valley Only)
To view a map of the current City Council boundaries, follow this link.
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Which Boards or Committees are you interested in participating on (top 3 areas of interest)?
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Administrative Review Board
Board of Adjustments
Clean & Beautiful Committee
Healthy West Valley Committee
Historical Preservation Commission
License Hearing Board
Planning Commission
Professional Standards Review Board
Sister City Committee
Reason for your interest in this board or committee?
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How did you hear about this board or committee?
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Are you currently serving on any other City board or committee?
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If yes, which board or committee?
Have you had previous experience serving on a city board or committee?
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Please list any community service / activities (past and present).
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Please list any professional activities.
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Please list any civic / professional organization memberships.
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