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2. As a candidate to a public agency legislative body this application (which includes the information you enter into it) will be available to the City Council and the public upon request. This includes attachments to the application (cover letter, resume, etc.).
4. Date*
   Date
5. Board, Commission, Committee*
   -- Select One --Planning CommissionParks and Cemetery BoardBlaine Tourism Advisory CommitteePublic Works Advisory CommitteeCivil Service CommissionAd Hoc Downtown Advisory Committee

   I am interested in serving on (please choose one).

7. I live within the City limits of Blaine*

   1. Yes
   2. No
8. I am a citizen of the United States*

   1. Yes
   2. No
9. I have lived within the City limits of Blaine for two years

   1. Yes
   2. No

   Answering "no" may impact your ability to serve depending on which vacant board, commission, or committee you are applying for.
11. Name*
12. Email Address*
    You will be informed of the status of your application via the email address you provided.
14. Address*
15. Phone Number
17. Occupation
    If retired, please indicate occupation before retirement.
19. Education
21. Personal/Community Activities
23. Qualifications Related to the Position
25. Describe why you are Interested in Serving on the Board, Commission, or Committee
27. DO YOU OR YOUR SPOUSE HAVE A FINANCIAL INTEREST IN, OR ARE YOU AN EMPLOYEE OR OFFICER OF ANY BUSINESS OR AGENCY WHICH DOES BUSINESS WITH THE CITY?*

    1. Yes
    2. No
29. If yes, please explain:
31. Applicant Signature*
    By signing this Application, I hereby certify that the facts set forth in this Application and supporting documentation are true and complete.
32. Date*
    Date
34. Other boards, commissions, or committees you would be interested in serving on:

    1. Public Works Advisory Committee
    2. Planning Commission
    3. Parks and Cemetery Board
    4. Blaine Tourism Advisory Committee
    5. Civil Service Commission
36. Upload Documents
    While not necessary, supporting documents can be uploaded here if you wish to do so.
38. As a candidate to a public agency legislative body this application (which includes the information you enter into it) will be available to the City Council and the public upon request. This includes attachments to the application (cover letter, resume, etc.).
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field