Boards and Committees Application

2. Application Submitted For:

   (Select all that apply)
   Specific membership requirements may apply; see description of Boards & Committees for more information
   
   

   1. Animal Rescue and Adoption Committee
   2. Big Spring Economic Development Corporation Board of Directors
   3. Board of Adjustments & Appeals
   4. Civil Service Commission
   5. Colorado River Municipal Water District Board of Directors
   6. Convention & Visitors Bureau Board
   7. McMahon/Wrinkle Airpark Development Board
   8. Planning & Zoning Commission
   9. Zoning Board of Adjustments
   10. 911 Committee

4. Name

5. Address

7. City / Zip

8. Phone Number

10. Resident of Big Spring since

11. Referred by

13. Occupation / Business Affiliation

14. Occupation / Business Address

16. Email Address

17. -- Select One --YesNo

19. 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.

    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.

21. <p style="text_align:right;">_____________________________________________</p> <p style="text_align:right;">Applicant's Signature</p>

    _____________________________________________

    Applicant's Signature

22. Date

24. 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.</br> <b>RETURN TO: City of Big Spring c/o City Manager's Office, 310 Nolan St, Big Spring, TX 79720</b>

    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

26. Tell us about yourself. Feel free to attach additional sheets, if necessary.

    Tell us about yourself. Feel free to attach additional sheets, if necessary.

28. Based on your board selection(s), do you meet the membership criteria?

    Based on your board selection(s), do you meet the membership criteria?

29. 1. Yes
    2. No

31. Which criteria?

33. Education and/or Professional Licenses:

35. Previous Municipal Experience (Positions, Dates, Where):

37. What personal qualifications can you bring to this board(s)?

39. What is your personal vision for the city?

41. Why do you want to serve on this board(s)?

43. Anything else you would like us to know?

45. 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.

    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.

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

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