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2. 
4. Name:*
6. Address:*
8. City:*
9. State:*
10. Zip:*
12. Phone Number:*
13. Email Address:*
15. Are you currently a resident of the City of Bismarck*
    -- Select One --YesNo
17. What board or commission are you applying to serve?*
    -- Select One --Animal Advisory BoardBismarck-Mandan Mayors' Committee for People with DisabilitiesBoard of AdjustmentCommunity Development Advisory CommitteeForestry Advisory BoardHistoric Preservation CommissionHuman Relations Committee Parking AuthorityPlanning & Zoning CommissionRenaissance Zone AuthoritySpecial Assessment CommissionVision Fund Committee
18. Descriptions of Boards, Commissions & Committees:
    View Descriptions of Each Board & Committee
20. List the skills or qualifications you could bring to this board, commission or committee:*
22. Please explain your reasons for wanting to serve on this board, commission, or committee:*
24. What is your principal occupation?*
26. List the associations or institutes with which you are closely associated, or serve as a director or officer:*
30. Downtown Parking District:
    
32. If applying for the Parking Authority, do you own property within the Downtown Parking District?
    -- Select One --YesNo
33. What is the address of your property within the Downtown Parking District?
37. If applying for the Historic Preservation Commission, please indicate if you have experience in architecture, history, architectural history, planning, archeology, or other historic preservation related disciplines, such as American studies, American civilization, cultural geography or cultural anthropology.

    1. Architecture
    2. Archeology
    3. Architectural history
    4. History
    5. Planning
    6. Other historic preservation related disciplines, such as American studies, American civilization, cultural geography or cultural anthropology
39. If applying for the Civil Service Commission, Historic Preservation Commission or Special Assessment Commission, please upload your resume.
43. If applying for the Special Assessment Task Force, please indicate any of the items below that apply to you.

    1. Own or Rent your Home
    2. Live in an Apartment
    3. Live in a Manufactured Home Park
    4. Live South of Bismarck Expressway
47. A majority of official members are required to be in attendance in order for boards, commissions & committees to conduct business.*

    By checking this box you agree to meet the attendance expectations and participate in events.
49. Signature of Applicant:*
51. By checking this box I acknowledge that I am electronically signing this application.*

    1. Electronic Signature
52. Date:*
    Date:
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit Submit and Print

* indicates a required field