City of Victoria Form Center

2. Name*
3. Phone Number*
5. Street Address of Primary Residence*
6. City/State/Zip*
8. Mailing Address*
10. Personal/Home Phone Number*
11. Work Phone Number
13. Email Address*
14. Fax
16. Occupation*
18. Describe any education, experience, special knowledge, or qualifications that relate to possible appointment to the selected board or commission:*
20. Describe any other volunteer experience:*
22. Explain why you would like to be appointed to the selected boards or commissions:*
24. List any additional information you feel is pertinent to your possible appointment:*
26. Have you attended any of the following:

    1. Citizens Academy
    2. Civilian Police Academy
    3. Civilian Fire Academy
28. References (Optional)
30. Length of Residence in City of Victoria*
32. Do you have the time to commit to this service? That is: to attend the meetings, study the matters to be brought before this board/commission/committee, and participate in all its activities. *

    1. Yes
    2. No
34. **There is no compensation for serving on any of the Boards/Commissions/Committees** Application will be considered active for two years. After two years, you must reapply for consideration.
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field