Boards and Commissions Application

City Clerk's Office
2757 East Point Street
East Point, GA 30344

Office: (404) 270-7090 | | Fax: (404) 765-1014
Email: CityClerk@EastPointCity.org
Website: www.eastpointcity.org

Boards & Commissions Application
*Please return this form via email, fax or mail to: City Clerk's Office (see above).

Name:*

(Full Name)

Ward:

Address:*

How Long?*

Primary Telephone:*

Secondary Telephone:*

Occupation*

(If retired, please list previous occupation)

Employer Name:*

Employer Address:*

Employer Telephone:*

Employer Email:*

Previous Experience

Please describe any special knowledge, qualifications or expertise that relates to your appointment:*

Please give a brief statement why you would like to be appointed to a Board or Commission: *

Please indicate your first and second preference below:*

	Preference #1	Preference #2
Alcohol & Beverage Review Board
Board of Appeals
Budget Committee
Civil Service Board of Appeals
Cultural Enrichment Commission
Downtown Architectural Review Board
East Point Board of Ethics
East Point Building Authority
East Point Business & Industrial Development Authority
Finance Committee
Municipal Utility Advisory Commission
Planning & Zoning Commission

Are you or a member of your family involved in any business transaction with the City of East Point?*

YesNo

If yes, please explain:

Recognizing that serving on a Board or Commission is voluntary, and can be time consuming, are you committed to attending all regularly scheduled meetings?*

YesNo

Please Note: While there is no guarantee of an appointment, all applications will be considered equally. Applications will be kept on file for one calendar year and then updated or withdrawn by the applicant.

Print Name:*

(Full Name)

Date*

MonthDayYear

Signature:*

Mission Statement
To provide exceptional city services in the most professional, courteous and effective manner to enhance the quality of life in the City of East Point.

FOR OFFICE USE ONLY

Date Application Received:

MonthDayYear

New Applicant?

YesNo

If no, applicant previously served on:

Scheduled Interview Date:

MonthDayYear

Applicant Appointed?

YesNo

Statement & Oath Completed?

YesNo

Applicant Appointed to: