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2. Board, Commission, or Committee applying for*
   -- Select One --Select OneAirport Advisory CommitteeBeautification Advisory Group (Christmas)Board of Adjustments CommissionParks Advisory CommitteePlanning & Zoning CommissionWildlife Advisory Committee
4. First Name*
5. Last Name*
7. Address:*
9. City*
10. Zip*
12. Phone Number*
14. Email Address
16. Occupation (If retired, please indicate former occupation)*
18. Residency Information
20. Length of Residency in Granite Shoals*
22. Are you a registered voter*

    1. Yes
    2. No
24. Education/Training
26. Professional and/or Community Activities
28. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
30. If yes, which
32. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
34. If yes, which one(s) and when
36. Qualifications that make you a good candidate for this position
38. Disclosures (check or answer below)
40. Do you have any known code violations or deliquent taxes?

    1. Yes
    2. No
42. Are you a party to any litigation involving the City?

    1. Yes
    2. No
44. Do you have any conflicts of interest which might affect your ability to serve?

    1. Yes
    2. No
46. If yes to any of the above, please explain:
48. Term Preference (for P&Z and BOA rotating appointment terms only)

    1. One-Year Term
    2. Two-Year Term
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50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field