North Road Extension Advisory Task Force Application

I, the undersigned, declare myself to be a resident of the Kenai Peninsula Borough and that I reside in the area accessible via the North Road Extension or along the area which would be accessible if the North Road Extension were to reasonably be extended.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input - Please enter a valid USA Zip Code.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input - Please enter a valid USA Zip Code.

Invalid Input - Please enter a valid phone number and include the area code.

Invalid Input - Please enter a valid email address.

Invalid Input

I certify that the information provided in this application for appointment is true and complete and that I meet the specific residency requirements of this office.
I further acknowledge that by typing my initials below I intend to fully sign this document.

Invalid Input

Prove you're not a robot.
Click here to load new characters. Invalid Input