Haltom City Application to Serve on a Board/Commission

Request to Serve on a Board or Commission All information must be furnished in order to be considered:
Name:	Please check all the Boards & Commissions of interest:
Phone #:	Animal Advisory Beautification Civil Service Crime Control & Prevention Economic Development Fire Services	Housing Authority Library Parks & Recreation Planning & Zoning Sexually Oriented Board of Appeals Zoning Board of Adjustments
Email:
Age(optional):
Employer:	Occupation:	Education:

Home Address:
Street	City	State	Zip Code

Work Address:
Street	City	State	Zip Code

List any special knowledge or experience applicable:	Other information(civic activities, etc.):
I have been a resident of Haltom City for years.		Voter Registration #: