Advisory Planning Commission Application

I, the undersigned, am a qualified voter and declare myself to be a resident and applicant for the nomination to the office of the following advisory planning commission:

Select one:(*)

Name(*)

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Mailing Address(*)

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City(*)

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State(*)

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Zip(*)

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Residence Address(*)

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City(*)

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State(*)

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Zip(*)

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Email(*)

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Work Phone

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Home Phone

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Mobile Phone

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How long have you lived in the area served by this Advisory Planning Commission?(*)

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What knowledge, experience, or expertise will you bring to this board?(*)

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Provide at least ONE identifier:

Voter #

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SSN

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Date of Birth

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If you would like to submit a copy of your resume, please email it to [email protected].

APPLICANT CERTIFICATION: I certify that the information in this Application for Appointment is true and complete and that I meet the specific residency and voter registration requirements of this office. I further acknowledge that by typing my initials below I intend to fully sign this application.

Type your initials to sign(*)

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Prove you're not a robot.(*)

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