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2. Name*

   Please write your full name

3. Address*

   Please indicate your address (note, all boards require residency within the City of Edwardsville).

5. Phone Number*

   Please write your preferred phone number for contacts

6. E-mail

   Please provide your e-mail address

8. Board Selection*

   1. Cemetery, Parks, & Public Spaces (CPPS) Board
   2. Planning Commission

   The list above is of the Citizen Advisory Boards and Commissions. Please complete an individual form for each board, committee, or commission for which you would like to be considered. Additional forms may be picked up at City Hall. If you have any questions or need additional information about the specific group(s) you are interested in, please contact the City Clerk’s office at 913-356-6000.

10. Interest

    Please state why you are interested in serving on this board, committee or commission and indicate what expertise and /or capabilities you would bring to this board, committee, or commission.

12. Experience

    What other boards (city, county, school, etc.) are you currently serving on? What other boards (city, county, school, etc.) have you served on?

14. Thank You!

    When an opening on a board, committee or commission occurs, the Mayor and City staff will review interest forms on file. If your form is selected, you will be contacted to confirm that you are still interested in serving on this board, committee or commission before an appointment is made. If you wish additional information, please contact the City Clerk’s office at 913-356-6000.

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16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit

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