2. DECLARATION OF CANDIDACY FOR MAYORAL, ASSEMBLY, AND SCHOOL BOARD MEMBER SEATS
   
4. General Information
6. Name:*
8. I am a qualified voter and declare
   myself to be a resident and candidate
   for nomination to the office of:
   
   *
   -- Select One --Select OneBorough Mayor - Three year termSchool Board Member - Three year termSchool Board Member - Three year term
10. My current residence address is:*
12. I have been a resident of the Kodiak Island Borough since:*
14. Business Address:*
16. Home Phone Number:*
18. Business Phone Number:*
20. Email Address:
22. Residency Information
24. Length of Residency in League City:*
26. Are you a registered voter:*

    1. Yes
    2. No
28. Education and Hobbies
30. High School:
32. College:
34. Trade or Business School:
36. Hobbies:
38. Organization Membership Information
40. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
42. If yes, which:
44. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
46. If yes, which:
48. Please list organization memberships and positions held:
50. Please List Areas of Special Interest
52. Please Enter Basic Resume Information Below
Leave This Blank:


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

    This field is not part of the form submission.

56. Submit Submit and Print

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