Please complete the online form below.

Personal Information

Select the Board, Commission, or Committee applying for:

Planning & Zoning Commission Board of Appeals Design Review Committee Board of Ethics Clean And Beautiful Commission Design Review Committee Hapeville Development Authority

Development Authority of the City of Hapeville Main Street Board Personnel Board Planning Commission TPD Committee Steering Committee Other

Name:*

Home Address:*

Home Phone Number:*

Business Phone Number:*

Occupation:*

Email Address:*

Why do you want to serve on a Board or Commission?

Are you available in the evenings? *

Yes

No

Residency Information

If yes, which evenings are best for you? *

Monday Tuesday Wednesday

Thursday Friday

Length of Residency in City:*

Education and Hobbies

High School:

College:

Trade or Business School:

Hobbies:

Organization Membership Information

Are you currently serving on other Boards, Commissions, or Committees?*

Yes

No

If yes, which:

Have you served on a Board, Commission, or Committee before?*

Yes

No

If yes, which:

Please list organization memberships and positions held:

Please List Areas of Special Interest

Please Enter Basic Resume Information Below

Please provide three references:

Electronic Signature (First, Last): Please be aware that an electronic signature is as legally binding as a handwritten signature.