Forms • Douglas, WY • CivicEngage

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Board & Commission Volunteer Application

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Name of Applicant*

Street Address*

Mailing Address*

Home Phone*

Cell Phone and/or Work Phone*

Email address*

Are you a resident of the City of Douglas?

Yes

I am interested in serving on the following Board or Commission (select all that apply)

	Douglas Planning & Zoning Commission/Board of Adjustments
	Historic Preservation Commission
	Converse County Tourism Board
	Douglas Housing Authority Board
	Federal Aid to Urban Systems Board

	Douglas Board of Appeals
	Steering Committee Member (when applicable)
	Focus Grroup Member (when applicable)
	Other:

Have you served on any of these Boards/Commissions previously?

Yes

If "Yes", please indicate which Boards/Commission and when you served.

In what community/communities did you previously serve?

In what position(s) would you be willing to serve? Please select all that apply.

	Chairperson
	Vice Chairperson
	Secretary

	Treasurer
	Board or Commission Member

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

If "No", please provide a description of your question(s).

Give a brief explanation why you are seeking appointment(s).*

Date*

* indicates required fields.