City Commission Interest Form

Experiences
Prior experience on City commissions or other volunteer boards:
Prior related work experience:
Civic, professional and community activities:
Why do you want to be on a Fridley commission?
What strengths, skills and abilities do you believe you will add to the commission?

Additional Information
Do you have other commitments that may impact your ability to attend commission meetings (e.g., travel for work, etc.)?
If yes, how often?
Additional comments

Recommendations/Referrals
Did a current City Council member, advisory commissioner or member of staff recommend/refer you apply for a City commission?
If so, who?

First NameLast Name
Member email
example@example.com
References
Do you have connections within the community that would recommend you for appointment to a commission?
Reference 1 - Email
example@example.com
Reference 1 - Name

First NameLast Name
Reference 2 - Name

First NameLast Name
Reference 2 - Email
example@example.com
Reference 3 - Name

First NameLast Name
Reference 3 - Email
example@example.com

Application Notice

The information provided by you on this application will be used to determine your eligibility for appointment to a City of Fridley commission. Participation as a commission member is strictly voluntary, and you are not required by law to provide this information. If you do not furnish this information, however, the City may have difficulty determining your eligibility and/or contacting you. Pursuant to Minnesota Statute § 13.601, some data you provide is public information upon application. Upon appointment, additional data about you becomes public information. Any information required on this form that is not public will only be accessible to you or City staff. You may contact CityClerk@FridleyMN.gov for more information.
Please acknowledge if you have read the application notice.*

Yes, I have read and understand the notice.
Should be Empty:

Employer Information