2. 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.
4. PERSONAL INFORMATION
6. Full Name*
8. Physical Address Where you Claim Residency:*
10. Phone Number(s)(numeric only): *
12. Email Address(s):*
14. Employer/Occupation:*
16. Select the the Board, Committee, Commission, or Work Group for which you are applying:*
    -- Select One --Select OneArchitectural/Engineering Review BoardCitizens Board of EqualizationKodiak Fisheries Development AssociationKodiak Fisheries Work GroupParks and Recreation CommitteePlanning and Zoning Commission*Solid Waste Advisory BoardBay View Road Service AreaFire Protection Area No. 1Monashka Bay Road Service AreaMission Lake “Tide Gate” Service AreaService Area No. 1Trinity Island Street Light Service AreaSolid Waste Advisory BoardTrinity Islands Street Lights Service Area BoardWomens Bay Service Area BoardWoodland Acres Street Light Service Area
18. Other:
20. PLEASE ANSWER THE FOLLOWING
22. Are you a Borough Resident?*

    1. Yes
    2. No
23. If yes, for how long?*
24. Are you a registered voter?*

    1. Yes
    2. No
26. *(Planning And Zoning Commissioners, Once Appointed, Will Be Required To Fill Out APOC Financial Disclosure Forms)*
27. Are You Willing To File APOC Financial Disclosure Forms?*

    1. Yes
    2. No
29. BACKGROUND INFORMATION
31. Please List Any Current Memberships Or Organization(S) You Belong To Or Participate In:
33. What Background, Special Training, Education, Experience, Or Credentials Do You Possess And Will Bring To Your Selection(S):
35. Why Are You Interested In Serving On The Selected Board, Committee, Commission, Or Work Group? Explain Your Main Reason For Applying. This May Include Information On Future Goals Or Projects You Wish To See Accomplished Or Any Additional Information That May Assist The Mayor And Assembly In The Decision-Making Process:
37. Additional Information, A Resume, Or Letter Of Interest May Be Uploaded But Is Not Required.
39. FOR CLERKS OFFICE STAFF ONLY
41. Registered Voter of the Borough:

    1. Yes
    2. No
42. Resident of the Service Area:

    1. Yes
    2. No
43. Date Provided to Mayor or Assembly:
    Date Provided to Mayor or Assembly:

    Date Provided to Mayor or Assembly:
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field