City of Springdale Application Form for Appointment to City Boards, Commissions, and Authorities
Name
*
First Name
Last Name
Email
*
example@example.com
Employer Name/Occupation
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City of Springdale Length of Residency
*
Are you a registered voter in Arkansas?
*
Yes
No
If you are not registered in Arkansas, which state are you registered to vote in?
*
Please check all boards/commissions/authorities you are interested in serving on:
*
A & P Commission
Airport Commission
Civil Service Commission
NWA Conservation Dist. Authority
NWA XNA Reg. Airport Authority
Planning Commission
Public Facilities Board
Public Housing Authority
Public Library Board
Shiloh Museum Board
Water & Sewer Commission
REFERENCES
Please include two (2) references below:
REFERENCE 1
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
REFERENCE 2
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please attach your most recent resume and cover letter with any information that you think would make you a good candidate for this position:
*
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