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Firestone Board, Commission or Committee Application

2. To be considered for a board or commission vacancy, please complete this application.
   
   Qualifications: All positions require residency within the Town of Firestone, and, in some instances, a particular area of experience or vocation is preferred. Additional information can be found on the Town’s website under Boards and Commissions, or you can contact the Town Clerk’s Office at 303-531-6264.
   
   The Board of Trustees will review candidate applications and, upon approval, will formally appoint individuals at a regularly scheduled Town Board meeting.
4. Name of Board, Commission or Committee*
   -- Select One --Cultural CommitteeFinance CommitteeFirestone Urban Renewal AuthorityParks, Trails & Recreation Advisory BoardPlanning & Zoning Commission
5. Applicant Name*
7. Address*
9. City*
10. State*
11. Zip*
13. Home Phone
14. Cell Phone
15. Work Phone
17. Email*
18. How long have you been a Firestone resident?*
20. Current Occupation
21. Employer
23. Do you currently serve, or have you previously served, on a board, commission or committee?*

    1. Yes
    2. No
25. If yes, which ones?*
27. Why are you interested in this particular board, commission or committee?*
29. List any abilities, skills, licenses, certificates, specialized training or interests applicable to this board, commission or committee.
31. If not appointed at this time, would you be interested in serving on any other boards, commissions or committees for the Town of Firestone? *

    1. Yes
    2. No
33. If so, please list the alternative board, commission, or committee of interest.
35. The Town of Firestone will make reasonable accommodations for access to town services, programs, and activities and will make special communication arrangements for persons with disabilities. Please call 303-531-6264 for assistance.
37. Check Here*

    I certify that all statements on this form are true and complete.

    1. I agree my electronic submission of this form constitutes my signature affirming the above information is true and correct.
39. Applicant Signature*
40. Date*
    Date
Leave This Blank:


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

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field