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2. First Name:*
3. Last Name:*
5. Home Address:*
7. City:*
8. State:*
9. Zip Code:*
11. Phone Number:
12. Email:*
14. District*
    -- Select One --District 1District 2District 3District 4District 5
15. Board, Commission, Committee*
    -- Select One --Community Improvement District (CID) Advisory CommitteeCommunity Planning Information (CPI) Construction Board of AppealsEconomic Development Steering Plan Committee Finance Oversight CommitteeParks & Recreation Advisory CommitteePlanning CommissionSPLOST Oversight CommitteeStonecrest Development Authority Stonecrest Film & Entertainment CommissionTransportation Advisory CommitteeUrban Redevelopment Agency (URA)Zoning Board of Appeals
17. Years of Residency in this Municipality
19. Experience/Professional Expertise/Education

    (Please provide dates of education and experience.)

21. Current of Prior Experience on Boards/Commissions/Committees
23. Civic Activities and Memberships

    (Roles with fraternal, business, church, or social groups-please provide dates)

25. Reasons for Wanting to Serve
27. Resume, Education, etc. (Optional)
29. Other File Upload
31. Other File Upload
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33. 1. Receive an email copy of this form.
34. Email address

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35. Submit

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