Application for Appointment to Commissions, Boards, Committees and Task Forces

2. First Name*

3. Last Name*

5. Address1*

7. Address2

9. City*

10. State*

11. Zip*

13. Email*

14. Home Phone

15. Cell Phone

16. Work Phone

18. Public Commission Directory*

    Please indicate the phone number(s) you would like published in our Public Commission Directory if you are appointed. Permission to release your phone number to the public is a requirement of the Data Practices Act.

    1. Home

    1. Cell

    1. Work
20. Mark up to 3 committees you are interested in serving on*

    1. Charter Commission
    2. Parks & Recreation Advisory Board
    3. Planning Commission
    4. Environmental / Greening Committee
    5. Lower Mississippi River Watershed Management Organization
    6. NDC4 (Cable Commission)

21. If you are interested in more than one committee, please list them in order of most desirable to least desirable.

23. More Info
    Learn more about each Board and Commission here...

25. How Many Years Have You Lived in West St. Paul*

26. Ward

27. Precinct

29. Employment / Job Title*

31. Employer Name & Address*

33. List your past and present civic activities or memberships which may be helpful to this committee.*

34. List two or three goals that you would like to see accomplished during your term on a commission.*

35. How did you become interested in serving on a committee?*

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36. Submit

* indicates a required field