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BOARD, COMMITTEE, AND COMMISSION APPLICATION

This application is subject to the Colorado Open Records Act and should not be considered confidential.
INSTRUCTIONS
  • Please complete a separate application for each board or commission membership
  • Feel free to attach a resume or additional pages (see "Attach Files" section at bottom of application)
  • All applicants must complete the Conflict of Interest disclosure
ELIGIBILITY REQUIREMENTS
  • Persons shall be eligable to serve on boards and commissions who live in the City of Longmont for one year prior and have been a qualified elector of the City of Longmont (registered voter) for one year prior to appointment (see exceptions below)
    • Some Boards, Committees or Commissions have different qualifications. Please contact the City Clerk's Office, the Board Liaison or the City's website for further information
  • Applicants may only serve on one City of Longmont Board, Committee or Commission at a time
Name of Board/Committee or Commission you are applying for:
If this Board, Committee or Commission consists of regular board members and alternative members, would you consider serving as an alternate?
Do you presently serve on another Board or Commission for any government entity?
If yes, please list board and entity:
FIRST NAME:        LAST NAME:
MAILING ADDRESS:   CITY:   STATE:   ZIP CODE:
HOME ADDRESS:   CITY:   STATE:   ZIP CODE:
DAY PHONE:        EVENING PHONE:
EMAIL ADDRESS:
Are you a registered voter in the City of Longmont? Not applicable for Longmont Downtown Development Authority, Longmont Area Visitor's Association or Cable Trust Board
Have you lived in Longmont city limits for at least one year? Not applicable for Longmont Downtown Development Authority, Longmont Area Visitor's Association or Cable Trust Board
Tell us about yourself and why you would like to be a member of this board, committee or commission. We're interested in how long you've lived in Longmont, what motivated you to apply, what life, education and/or employment experiences you have that will help you serve on this board, and any other information you would like to share about yourself.
What do you know about the issues facing this board, committee or commission and how do you think you can have an impact on these issues?
WHAT IS YOUR CURRENT OCCUPATION?
Employer:        Phone:
WHAT SPECIAL QUALIFICATIONS DO YOU HAVE FOR SERVING ON THIS BOARD?
Skills/Licenses/Training/Certificates:
Volunteer Work/Experience:
Education:
Institution:    Years Completed:    Degree:
If you are appointed, you'll be asked to attend regular meetings (typically monthly meetings) as well as help out with occasional special projects. The time commitment can vary but is typically around six hours per month minimum. Are you able to fulfull this time commitment?
Are there certain times when you wouldn't be available (for instance because of job hours or another regular commitment?)
Where did you hear of this vacancy?
This application is subject to the Colorado Open Records Act and should not be considered confidential
CITY OF LONGMONT BOARD AND COMMISSION APPLICANTS
CONFLICT OF INTEREST DISCLOSURE
Several state laws and municipal ordinances prohibit conflicts of interest on the part of the City board and commission members. A member of a board or commission shall not perform an official act that may have an economic benefit on a business or other undertaking (whether for profit or not) in which the member has a direct or substantial financial interest. Board and Commission members must not be interested in any contract made in their official capacities; or made by any other body, agency or board of which they are members or employees.
1. ALL BOARD AND COMMISSION APPLICANTS
Do you have any direct or indirect financial or economic interest in any business or other undertaking (whether or not for profit) that may have business coming before the board or commission for which you have applied?
If Yes, please describe that interest in the space immediately below
2. HOUSING AUTHORITY APPLICANTS
Do you have any interest, direct or indirect, in any project property included or planned to be included in any housing authority project?
If Yes, please describe that interest in the space immediately below
Do you have any interest, direct or indirect, in any contract or proposed contract for materials or services to be furnished or used in connection with any project?
If Yes, please describe that interest in the space immediately below
3. LONGMONT DOWNTOWN DEVELOPMENT AUTHORITY
Are you, or the company you work for, interested in any matter that might come before the authority in which you or your company would receive a benefit or incur a cost substantially greater than other property owners within the Downtown Development Authority District?
If Yes, please describe that interest in the space immediately below
4. PARKS AND RECREATION ADVISORY BOARD APPLICANTS
Do you have any interest, directly or indirectly, in any contract relating to the establishment or maintenance of any of parks properties; or in any contract to spend money involving establishment or maintenance or parks properties?
If Yes, please describe that interest in the space immediately below
5. WATER BOARD APPLICANTS
Do you have any interest, direct or indirect, in any contract involving city waterworks or any contract for spending moneys in connection with city waterworks or in any contract or transaction with the City, except: as provided in an employment contract with the City?
If Yes, please describe that interest in the space immediately below

(Optional) Upload your resume or other information pertinent to your application: