Nominate Yourself for a Board or Committee
Fire Districts and Special Committees
PART A - BOARD OR COMMISSION SOUGHT?
Which Board or Committee are you making an application for?
*
Please Select
Disability Awareness Committee
North Palos Fire Protection District Trustee
PART B - BASIC INFORMATION
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.
Do you have a disability or are you a caretaker of a person with disabilities? (Answer this question ONLY if you are applying for the Disability Awareness Committee)
YES
NO
Email
*
example@example.com
PART C - EDUCATION
Name of High School Last Attended:
Highh School Location:
Post Secondary Education
List the last four post-secondary educational institutions you attended, listing the name, location and dates attended in addition to any certfications or degrees received.
PART D - INTEREST AND QUALIFICATIONS
Why would you like to serve on the board(s) or committee(s) you have selected?
*
Unique Characteristics, Qualifications and Experiences:
*
What unique characteristics, qualifications and experiences would you bring to the board or committee?
If you have any written statements or a Resumé available, please upload it here:
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