Board Member Nomination and ApplicationDate (required)Contact InformationApplicant Full Name (required)Email Address (required)Home Address (Enter your home address, city, state and zip.) (required)Work Address (Enter full work address, city, state and zip.) (required)Cell Phone (required)Work PhonePreferred Address: Would applicant prefer home or work address used as mailing address?WorkHomeNoneDo you prefer to have your personal contact information remain private? (required)YesNoBoard ApplicationName of Board you are applying for (required)Nominated by (if applicable)Unique qualifications and/or perspectives you would bring to a Board or Commission: (required)Are you a current member of another board(s). If yes, please list board names.Have you ever been a member of another board(s)? If yes, list board and dates.Additional InformationAre you or any of your family members a White City Metro Township employee?YesNoHave you ever been convicted of a felony? Answer yes or no. If yes, please explain. (required)Submit your Resume here as an attachment. You may submit your resume as a PDF, Doc, Docx, or Text document.There was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.
