Board or Commission Candidate Application

Message

For manual submission fax to (972) 423-9587 or mail to City of Plano, City Secretary, P.O. Box 860358, Plano, TX 75086-0358.

Last Name *

First Name *

Middle Name

Personal Information

Home Address * Plano, Texas Zip * Telephone * Fax E-mail
Plano Resident for * Years
County * Driver License # * Voter Registration # *

Occupational Information

Employer Name Occupation Address Telephone Fax E-mail Business Owner? *

Yes No

Qualification Statement

By checking the buttons below I affirm that:

I have been a resident of Plano for the past consecutive 12 months;

I am qualified to vote;

I am not indebted to the City of Plano;

If appointed I will meet or exceed the minimum attendance requirements for my board; and

I am aware of the City’s Code of Conduct.

Please select a Board/Commission, provide qualifications/skills that you will contribute and the reasons you would like to join this board. If additional space is required a one-page resume or separate document may be attached with the application. In addition, or in lieu of a resume or other document, you may attach a brief video introducing yourself and speaking to your qualifications/skills and interest in joining this board. The application will allow for two attachments.

File Attachment

1st Choice Qualification 2nd Choice Qualification 3rd Choice Qualification

Yes, I would be interested in serving on subcommittees that may be formed.

I will attend the following information session:

Previous Board, Commission, Civic or Community, or Work Experience that might benefit the City. (A one-page resume or additional information can be attached and submitted with the completed application.)

Organization

Location

Years

List any business or personal relationships with the City, which might create a conflict of interest or affect your ability to serve.

The submission of this application will be treated as the applicant’s representation of the information provided. Applications will remain on file for one year from the date of receipt and may be available to the public upon request.

The City of Plano is committed to compliance with the Americans with Disabilities Act (ADA) and related laws. Reasonable accommodations, including equal access to communications, will be provided upon request. Requests for reasonable accommodations, with regard to equal access to communications, should be directed to the City Secretary’s Office at (972) 941-7120.

Date Submitted:

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Application Number:

Personal Information

Occupational Information

Qualification Statement

File Attachment