2025 Queens Community Board Application

2025 Queens Community Board Application
Applications Close on February 14, 2025 at 5:00 p.m.

Instructions

Please review all of the application questions carefully. It is recommended you copy and paste your essay responses from a separate document into the corresponding fields in the application. If a question does not apply to you, please indicate that by writing “N/A” in the provided space.

Additionally, please have a photo or scan of a form of address (e.g., a driver’s license/state ID, IDNYC, or a recent utility bill) prepared to upload as part of this application.

If you have any technical issues with submitting this application or other questions, please email Director of Community Boards Michael Carlier at mcarlier@queensbp.nyc.gov prior to the deadline.

Please be aware that some information provided in your application may be subject to public disclosure under the New York Freedom of Information Law (FOIL).

If you are seeking a council member’s nomination for appointment, please reach out directly to that council member after you have submitted your application.

Contact Information
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide proof of address by uploading a photo or scan of a form of identification (e.g., a driver’s license/state ID, IDNYC, passport, or a recent utility bill).*

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Primary Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Email*
example@example.com
Eligibility

To be eligible to serve on a Queens Community Board, you must be a resident of New York City and must live, work, or have a professional or other significant interest in that board’s district.

If you are uncertain about which community board district in which you live, work, or otherwise have an interest, please visit boundaries.beta.nyc and search your address.
I am applying for membership on Community Board #*
Application Type*

New Applicant (not currently appointed by the Borough President to serve on a Community Board)Re-Applicant (currently appointed by the Borough President to serve on a Community Board)
Have you ever applied to serve on a community board before*

YesNo
If Yes, how many times have you applied to serve on a community board previously?*
If you currently serve or have previously served on a community board, please indicate the board, the date of appointment(s), and the length of service.
e.g. CB2 from 4/2015 to 6/2019
I am eligible to serve on this Community Board because: (select all that apply)*

I live in the districtI work in the districtI own a business in the districtI attend school in the districtI have a significant interest in the district
Please specify the address which qualifies you to serve on the board.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If your eligibility is based on working, owning a business, attending school, or another significant interest in the district, please provide a detailed explanation below.*
For how many years have you lived, worked, or otherwise had a significant interest in the district of the Board to which you are applying?*
Employment and Professional Information
Employment status*

Business OwnerNon-ProfitUnion MemberNYC EmployeeLobbyistState or Federal EmployeeSelf-Employed / FreelanceStudentPrivate SectorRetiredFamily ManagerUnemployedNot working by choice
Name of current employer/ business(es)/ school*
Type N/A, if not applicable.
Title/Position (if applicable)
If you are a New York City or State employee at a position at or above the level of Assistant Commissioner (or equivalent), please attach a copy of a mayoral waiver allowing you to serve on a Community Board.

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Address of employer, business, or school (if applicable)
List any special skills, interests, professional certificates, or licenses
Type N/A, if not applicable.
Conflicts of Interest

As public servants, all Community Board members are governed by the City's conflicts of interest law, Chapter 68 of the New York City Charter. The law's purpose is to ensure that public servants do not use or appear to use their public positions to benefit their private interests or those of their families or associates.
Would your service on a community board create a conflict of interest due to your personal, professional, or financial interests (e.g., you or a close family member work for a firm or city agency with or have a financial interest in matters that regularly appear before your community board)?*

YesNo
If you are unsure, please reach out us by emailing legal@queensbp.org or contacting the Conflicts of Interest Board by clicking here.
Do you have any interests as described that may come before a community board for review?*

YesNo
Please identify the nature of the interest.*
Do you have immediate family on the board you are applying to?*

YesNo
Please identify the family member.*
Statement of Interest

The following questions are optional for members seeking reappointment.
Because you are a reapplicant, the following "Statement of Interest" questions are optional.
1. Why have you chosen to apply to become a community board member?*
2. How will you be an effective board member?*
3. What specific skills and experience would you bring to the community board?*
4. Do you have any experience in public service and/or local civic engagement, such as involvement in a local community organization or club?*
Community boards meet at least once a month, and members are also expected to regularly attend committee meetings, public hearings, and trainings, which are typically held in person. Are you willing to consistently commit several hours each month to community board service?*

YesNo
If not, what are the barriers to you committing the necessary time?*
Demographic Questionnaire

The following information is requested to help ensure that community boards are diverse, inclusive, and representative. Please note that you are not required to answer these questions. If you wish not to answer these questions, please select 'Prefer not to answer.'

Demographic information provided in this section will be made public in an aggregated and anonymized form in an annual report issued by the Office of the Queens Borough President.
Gender Identification*

FemaleMaleNon-binaryOtherPrefer not to answer
If you selected "Other" for Gender Identification? Please specify.*
Tell us how you identify? (Please select all that apply)*

African American / BlackCaribbeanEast Asian / South East Asian / Pacific IslanderEuropeanNative American / American IndianLatina/o/e / HispanicSouth West Asian (Middle Eastern) / North AfricanSouth AsianSub-Saharan AfricanWhitePrefer not to answer
Is there any other background information you would like for us to know? (Please select all that apply)*

Parent / guardian of a pre-school aged childParent / guardian of a child (Pre-K to 12 grade)ImmigrantPerson with a disabilityVeteran / military serviceNon-native speaker of EnglishCaregiverLGBTQ+Not ApplicablePrefer not to answer
Is there anything else you would like us to know about how you self-identify?
Education (Select the highest level)*
Primary housing*
If you selected "Other" for Primary housing: Please specify.
I use the following transportation modes:
Personal vehicle

Not at allSometimesOftenMostly
For-hire vehicle (Uber, Lyft, car service, etc.)

Not at allSometimesOftenMostly
Bike or any micro mobile device such as an e-scooter or e-bike

Not at allSometimesOftenMostly
Manual wheelchair, electronic wheelchair or mobility scooter

Not at allSometimesOftenMostly
Subway/Train

Not at allSometimesOftenMostly
Bus

Not at allSometimesOftenMostly
Private Bus Service (Dollar Van)

Not at allSometimesOftenMostly
Access-a-ride or other paratransit service

Not at allSometimesOftenMostly
Walking

Not at allSometimesOftenMostly
How did you hear about the 2025 application for Community Board membership?
Certification Statement

I affirm that I am not employed by the Queens Borough President or by a City Council Member who may nominate appointees to the Community Board to which I am applying. I am not employed by the State or City of New York in a position at or above the level of Assistant Commissioner (or equivalent title). If employed in such a capacity, I have secured a mayoral waiver allowing me to serve on a Community Board and have attached it to this application. If I am employed by the City of New York in any capacity, I have clearly indicated this in the Employment section of this application.

I am a New York City resident above the age of 16 who lives, works, attends school, or otherwise has a significant interest in the district of the Community Board to which I am applying. If appointed, I understand it is my responsibility to notify the Office of the Queens Borough President of any changes in residence, employment, school enrollment, or any other factor that would affect my eligibility for Community Board membership.

I am fully aware that Community Board membership requires my regular attendance and participation at Board meetings, meetings of committees to which I will be assigned, and public hearings that may be convened. Excessive absences will constitute cause for my removal from the Community Board. I am both willing and able to make this commitment of time and effort to serve my community.

I agree to abide by all New York City conflict of interest laws and rules. In all my Community Board activities, I will seek to adhere to the principles of good government, honesty, accountability, and the avoidance of conflicts of interest, both perceived and actual.

I affirm that all information in this application is complete, truthful, and accurate to the best of my knowledge. I authorize the Office of the Queens Borough President to take reasonable and necessary steps to verify the accuracy of the foregoing statements and representations. I further agree to cooperate with said Office in any verification efforts.
I have read and agree to the Certification Statement. I hereby affirm that the above information is true and correct to the best of my knowledge, and I acknowledge that any falsification thereof shall lead to immediate termination if appointed.*
Your Full Name
Should be Empty:

2025 Queens Community Board Application

Applications Close on February 14, 2025 at 5:00 p.m.

Instructions

Contact Information

Eligibility

Employment and Professional Information

Conflicts of Interest

Statement of Interest

Demographic Questionnaire

Certification Statement