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2. APPLICATION FOR APPOINTMENT
   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.
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53. 1. Receive an email copy of this form.
54. Email address

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55. Submit Submit and Print

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