November 22, 2009
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Advisory Board and Committee Application
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First Name
*
Last Name
*
Home Address
*
City
*
State
*
Zip Code
*
Telephone
*
Email Address
If applicable, How long have you lived in Hallandale Beach?
Days Available to Attend Meetings:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Hours Available to Attend Meetings:
*
Mornings
Middays
Afternoons
Nights
Prior Work/Volunteer Experience:
Why Do You Want to Serve on a Board or Committee?
Please select in order of preference, among the following, a Board or Committee you are interested in serving as a member.
Beautification Board
Civil Service Board
Code & Permitting Committee
Education Committee
Historical Preservation Board
Human Services Committee
Marine Committee
Planning & Zoning Board
Police & Fire Pension Board
Public Transportation/Flood Mitigation Board
Parks & Recreation Board
Unsafe Structures Board
Please select in order of preference, among the following, a second Board or Committee you are interested in serving as a member.
Beautification Board
Civil Service Board
Code & Permiting Committee
Education Committee
Historical Preservation Board
Human Services Board
Marine Committee
Planning & Zoning Board
Police & Fire Pension Board
Public Transportation/Flood Mitigation Board
Parks & Recreation Board
Unsafe Structures Board
Please select in order of preference, among the following, a third Board or Committee you are interested in serving as a member.
Beautification Board
Civil Service Board
Code & Permitting Committee
Education Committee
Historical Preservation Board
Human Services Board
Marine Committee
Planning & Zoning Board
Police & Fire Pension Board
Public Transportation/Flood Mitigation Board
Parks & Recreation Board
Parks & Recreation Board
Unsafe Structures Board
What special qualifications do you feel you would bring to this board or committee?
Your application may be considered for other Boards or Committees than those you selected above. If selected, would you be willing to serve on any other board or committee?
*
Yes
No
Your application is valid for one year from the date submitted. During that time, it will be automatically submitted for any vacanacies which may occur. You will not be contacted prior to each submittal. Is this acceptable?
*
Yes
No
Please provide any additional information you feel would help the City Commission in appointing you to a Board or Committee:
* indicates required fields.
Hallandale Beach
400 South Federal Highway
Hallandale Beach, FL 33009
954-458-3251
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