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Board Application Form

  1. Please complete the online form below. Please be aware that the information given on your application is made available to the public. Staff will require the use of a mailing address, email address, and contact phone number to provide board and meeting information.

  2. PERSONAL INFORMATION

  3. RESIDENCY INFORMATION

  4. Registered to vote in Kodiak?*

  5. FOR SERVICE AREA BOARD APPLICANTS

  6. ORGANIZATION MEMBERSHIP INFORMATION

  7. Are you currently serving on other Boards, Commissions, or Committees?*

  8. Are you available for regular meetings?*

  9. Pursuant to KIBC 2.100.070 (A.6) and 4.15.070 (A.7) Other than by expiration of the members term, the assembly shall declare a seat vacant when a member of the board misses three consecutively held rgular meetings and is not excused.

  10. FOR CLERKS OFFICE STAFF ONLY

  11. Registered Voter of the Borough: Y______ N ______

  12. Applicant's Residence: Borough_______ City ______

  13. Date of Appointment

  14. Term Expires On

  15. Appointment Letter

  16. Roster

  17. Oath of Office

  18. APOC POFD Statement: N/A ________ Attached ________ On File ________

  19. Leave This Blank:

  20. This field is not part of the form submission.