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Boards and Committees Application

  1. Application Submitted For:
    (Select all that apply)
    Specific membership requirements may apply; see description of Boards & Committees for more information

  2. Name
  3. Address
  4. City / Zip
  5. Phone Number
  6. Resident of Big Spring since
  7. Referred by
  8. Occupation / Business Affiliation
  9. Occupation / Business Address
  10. Email Address
  11. By executing this document, the applicant does hereby certify and affirm the truth and accuracy of information contained herein. The applicant further authorizes the city council, or its designee, to verify any information. The applicant agrees to release and hold harmless the city from any caims incident to the verification of information contained herein.
  12. _____________________________________________

    Applicant's Signature

  13. Date
  14. NOTE: This application is information of public record. Public service opportunities are offered by the City of Big Spring without regard to race, color, national origin, religion, sex, or disability.
    RETURN TO: City of Big Spring c/o City Manager's Office, 310 Nolan St, Big Spring, TX 79720
  15. Tell us about yourself. Feel free to attach additional sheets, if necessary.
  16. Based on your board selection(s), do you meet the membership criteria?
  17. The City Council wants to assure public confidence in the integrity of local government and its effective and fair operation. Therefore, all Members shall comply with the laws of the nation, the State of Texas, and the City of Big Spring in the performance of their public duties. If you have been convicted of a MISDEMEANOR or FELONY, and/or placed on probation fined, or given suspended sentence such as pretrial diversion or deferred adjudication in court within the last ten years, disclosure of such should be forwarded under separate cover.
  18. Leave This Blank:

  19. This field is not part of the form submission.