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4. APPLICATION FORM MONTPELIER CITY BOARDS AND COMMITTEES

   Please use this form to express your interest in serving on a particular board/committee or commission. Here are the committee vacancies. Applicants are encouraged to reach out to committee chairs and committee members to learn more about the committee responsibilities and commitment. Contacts should be available on each committee page. Stipends of $50 per committee meetings are available for all committees. Paper versions are available in city hall. 

6. The Montpelier City Council is committed to seeking diversity on all boards, committees and commissions, including but not limited to geographic, racial, gender, cultural, age, socio economic diversity. Montpelier residency for applicants is preferred but not required.
   *Applications must be received the Friday prior to the scheduled council meeting to be considered by the City Council for appointment.
8. Name*
9. Email Address*
11. Address
13. City
14. State
15. Zip Code
17. Phone Number
18. Occupation
20. Please Fill out one application for each Board or Committee to which you are applying*
22. Are you currently serving or have you served on any City board or committee? If so, please list and give approximate dates.*
24. Please answer each question in as much detail as possible.
26. Why are you interested in serving on this board/committee?
28. What talents, skills, education/credentials and experiences would you bring to thsi board/committee?
30. What community and professsional activities have you been involved with that relate to this board/committee?
32. Why are you interested in serving on this board/committee?
34. Please share other comments or information you wish to provideto the Mayor and City Councilors.
36. ACKNOWLEDGMENT*

    1. I have read and accept the terms of board/committee appointment.

    By checking this box, I acknowledge that regular attendance (not missing more than 3 consecutive meetings or 1/3 of all meetings), active participation and contribution to the group’s goals and mission, as well as adherence to open meeting laws and public record laws are requirements of me as a committee member. I acknowledge that if I do not meet the requirements stated above, that my appointment may be reconsidered.
38. By e-signing this application, I certify that there are no misrepresentations, omissions or falsifications on this application.*
39. 
    
    Submitted on:*
    
    
    Submitted on:
41. Thank you for your interest in serving the City of Montpelier as a volunteer board or committee member. Your willingness to serve is greatly appreciated.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field