City of Irving Board Application

2. Title*

   1. Ms.

   1. Mrs.

   1. Mr.

4. Last Name*

5. First Name*

7. Address*

8. City*

9. Zip*

11. Primary Phone Number*

    000-000-0000

12. Secondary Phone Number

    000-000-0000

13. Email*

15. Most board members shall be qualified voters of the City of Irving and have resided in the City for not less than one year immediately prior to the date of appointment.

17. 1. Are you registered to vote in Irving?*

    1. Yes
    2. No

18. 2. How long have you been a resident in Irving?*

19. 3. What district do you live in?
    -- Select One --134567

21. 4. Are you now or have you ever served as a member on any Irving boards or commission? If Yes, list board(s) and year served.*

23. 5. List any civic or community activities you have been involved with.

25. 6. List any experiences (paid or unpaid) or qualification that directly relate to the board(s) you are interested in.

27. 7. List current place of employment or business affiliation. Include self-employed, retired, etc.*

29. 8. What is your work experience?

31. Enter your first, second and third choices to indicate which boards or committees you are interested in.

33. First Choice*
    -- Select One --Advisory Committee on DisabilitiesAnimal Services Advisory CommitteeArts BoardBoard of HealthBuilding and Standards CommissionConstruction Board of AppealsConvention and Visitors Bureau BoardGreen Advisory BoardHousing and Human Services BoardLibrary BoardMuseum BoardParks and Recreation BoardPlanning and Zoning CommissionTIF Zone No. 1 BoardYouth CouncilZoning Board of Adjustments and Appeals

34. Second Choice
    -- Select One --Advisory Committee on DisabilitiesAnimal Services Advisory CommitteeArts BoardBoard of HealthBuilding and Standards CommissionConstruction Board of AppealsConvention and Visitors Bureau BoardGreen Advisory BoardHousing and Human Services BoardLibrary BoardMuseum BoardParks and Recreation BoardPlanning and Zoning CommissionTIF Zone No. 1 BoardYouth CouncilZoning Board of Adjustments and Appeals

35. Third Choice
    -- Select One --Advisory Committee on DisabilitiesAnimal Services Advisory CommitteeArts BoardBoard of HealthBuilding and Standards CommissionConstruction Board of AppealsConvention and Visitors Bureau BoardGreen Advisory BoardHousing and Human Services BoardLibrary BoardMuseum BoardParks and Recreation BoardPlanning and Zoning CommissionTIF Zone No. 1 BoardYouth Council Zoning Board of Adjustments and Appeals

37. Section 552.024 of the Texas Public Information Act provides that any appointed official of a government body shall choose whether to allow public access to the information in custody of the government body that relates to the person's home address or telephone number.

38. Allow public access to my address and phone number*
    -- Select One --YesNo

40. Section 552.137 provides that the email address of a member of the public that is provided for the purpose of communication electronically with a government body is confidential and not subject to disclosure.

41. Allow public access to my email address:*
    -- Select One --YesNo

43. Note:
    The deadline to apply for the November appointment is Friday, Sept. 27. Applicants are scheduled to meet with City Council members for board interviews in October and board appointments are made in November.

    The deadline to apply for the November appointment is Friday, Sept. 27. Applicants are scheduled to meet with City Council members for board interviews in October and board appointments are made in November.

45. Your application will be kept on file with the City Secretary's Office for one year. If you have any questions please call (972) 721-2493.

    Your application will be kept on file with the City Secretary's Office for one year. If you have any questions please call (972) 721-2493.

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field