Application for Board Membership
APPLICATION FOR BOARD MEMBERSHIP
HOME PHONE: ____________________________BUS. PHONE:________________________CELL: ____________________
EMAIL: ________________________________________________________________________________________________ I WOULD LIKE TO BE CONSIDERED FOR MEMBERSHIP ON THE FOLLOWING CITY BOARDS / COMMITTEES - Rank your first choice by placing "1" in the box to the left. If you would consider an alternative appointment, if not appointed to the 1st choice, please place a "2" and so on to the left of the alternative Boards/Committees.
_____ BOARD OF ADJUSTMENT, CODE ENFORCEMENT, AND APPEALS
Five (5) member board - 3 year term - No residency requirement. Suggested background: Engineer,
Architect, Building Contractor, Electric Contractor, Home Inspector, Plumbing Contractor, and/or Mechanical Contractor.
_____ PLANNING COMMISSION
Seven member (7) and two (2) alternate member board - 3 year term - Majority of membership must be City residents. Others may be residents of Pasco County.
_____ LIBRARY BOARD
Five (5) member board - 3 year term - No residency requirement, must be a patron of Library.
_____ AIRPORT AUTHORITY
Seven (7) member board - 3 year term - May live outside of City; suggested background is in an aviation related business, club or activity.
_____ HISTORIC PRESERVATION BOARD
Five (5) member board - 3 year term - Must live in the City. Preference: Interest or background in Architecture, local history, building contracting and/or community planning.
_____ PARKS & RECREATION ADVISORY BOARD
Seven (7) member board - 3 year term - Must be a Pasco County resident.
_____ MAYOR'S YOUTH COUNCIL
Seven (7) member board - 2 year term, except that of the seven members first appointed, three shall serve for a term of seven months, four shall serve for a term of one year and seven months. The members will be Zephyrhills area residents who are actively enrolled in a public, private high school, or home schooled in grades nine through twelve.
PLEASE ANSWER THE FOLLOWING:
ARE YOU A RESIDENT OF THE CITY?
ARE YOU A RESIDENT OF THE COUNTY?
ARE YOU A REGISTERED VOTER? _____ YES _____ NO PROPERTY OWNER? _____ YES _____ NO
WHY DO YOU WISH TO SERVE ON THIS CITY BOARD/COMMITTEE? (Please let us know why you are applying)
WHAT IS IT IN YOUR BACKGROUND THAT HAS PREPARED YOU FOR THIS VOLUNTEER ROLE? (education, other boards you have served on, where you are employed, your job, interests, hobbies, etc.)
DO YOU NOW OR HAVE YOU EVER SERVED ON A GOVERNMENT APPOINTED BOARD OR COMMITTEE? IF SO,WHERE AND UNDER WHAT CIRCUMSTANCES?
WHAT CAN YOU CONTRIBUTE TO THIS BOARD:
You may submit this form via email: firstname.lastname@example.org or print and fax to:
Attn.: City Clerk (813) 780-0005.