2. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OnePlanning CommissionPublic Safety CommissionRecreation CommissionGeneral Plan Citizens' Advisory Committee
4. Personal Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Home Phone Number*
19. Occupation*
21. Email Address*
23. Education and Hobbies
25. High School
27. College
29. Trade or Business School
31. Organization Membership Information
33. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
35. If yes, which
37. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
39. If yes, which
41. Please list organization memberships and positions held
43. Reason For Seeking Appointment

    Please list reason(s) why you are interested in the Board and/or Commission

45. Please List Areas of Special Interest
46. Return Completed Form to:

    City of Avenal City Clerk Office
    919 Skyline Blvd.
    Avenal, CA 93204

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

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50. Submit

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