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Application for Appointment

2. APPLICATION FOR APPOINTMENT
   To Boards, Commission and Committees Advising the Story County Board of Supervisors

   To Boards, Commission and Committees Advising the Story County Board of Supervisors

3. 

5. Date
   Date

7. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OneAssessor's Examining BoardASSETBoard of AdjustmentBoard of HealthBoard of ReviewBooSTCivil Service CommissionCommission of Veterans AffairsCompensation BoardCondemnation Compensation BoardConservation BoardPlanning & Zoning Commission

9. Applicants for Planning and Zoning Commission and Board of Adjustment must be eligible electors and reside outside of city limits in rural, unincorporated Story County.

11. Personal Information

13. First Name*

14. Last Name*

16. Home Address*

18. City*

19. State*

20. Zip*

22. Occupation*

24. Address at Work

26. City

27. State

28. Zip

30. Home/Cell Phone Number*

31. Business Phone Number*

33. Email Address

35. Education

37. List Names of Boards of Commissions in Order of Preference

39. Selection One
    -- Select One --Assessor's Examining BoardASSETBoard of AdjustmentBoard of HealthBoard of ReviewBooSTCivil Service CommissionCommission of Veterans AffairsCompensation BoardCondemnation Compensation BoardConservation BoardPlanning & Zoning Commission

40. Selection Two
    -- Select One --Assessor's Examining BoardASSETBoard of AdjustmentBoard of HealthBoard of ReviewBooSTCivil Service CommissionCommission of Veterans AffairsCompensation BoardCondemnation Compensation BoardConservation BoardPlanning & Zoning Commission

41. Selection Three
    -- Select One --Assessor's Examining BoardASSETBoard of AdjustmentBoard of HealthBoard of ReviewBooSTCivil Service CommissionCommission of Veterans AffairsCompensation BoardCondemnation Compensation BoardConservation BoardPlanning & Zoning Commission

43. Why do you wish to serve on this board?

45. What qualifications do you feel you have?

47. Do you have anything else to add?

49. Click Here to Upload Supporting Documents such as Resumes or DD-214s

51. THANK YOU FOR YOUR INTEREST IN SERVING STORY COUNTY.

Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit Submit and Print

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