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Application for Boards and Commissions Membership

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Boards and Commissions for the City of Fort Dodge advise the City Council and Mayor in the formulation of policy and provide increased communications with the public. Because of their importance in this regard, Boards and Commissions should be broadly representative of the community in terms of expertise, interest and cultural diversity.

* Denotes a required field

First Name*

Last Name*

Address*

Address 2

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Email Address*

Confirm Email Address*

Current Occupation*

Please Do Not Complete The Following Field

Learn more about each City Board and Commission online by visiting https://www.fortdodgeiowa.org/boards/.

For which Board(s) or Commission(s) are you applying? (Check all that apply)*

1) Why do you want to be a member of a Board or Commission?*

2) List any abilities, skills or interests which are applicable to the Board(s) or Commission(s) for which you are applying:*

3) Are you able to attend meetings when called?*

Yes No

4) Are you committed to serving the entire term if selected?*

Yes No

5) Please specify any activities which might create a serious conflict of interest if you were appointed to a particular Board or Commission.*

6) List any licenses, certificates or other specialized training applicable to the Board(s) or Commission(s) for which you are applying.*

7) Is there any additional information or references you believe may be helpful in considering your application?*

All applicants are strongly encouraged to attend a regularly scheduled meeting of the Board(s) or Commission(s) for which they are applying.

By submitting this form, you affirm that the information contained in this application is true and accurate to the best of your knowledge and that you are the person named above. In addition, you acknowledge that upon receipt by the City, this form is a public record and its contents will be provided to anyone requesting a copy.

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Communications

City Hall

819 1st S Ave
Fort Dodge, IA 50501
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Phone: (515) 576-4551
Staff Directory
Office Hours:
Monday - Friday
8:00 A.M. to 4:30 P.M.

City of Fort Dodge, Iowa

The official government website for Fort Dodge, Iowa

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Application for Boards and Commissions Membership

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