Please complete the online form below. You may only serve on one board or commission at a time. To apply for a position on the Senior Advisory Board, the applicant must be 60 years of age or older.

Today's Date (mm/dd/yyyy):*

Personal Information

Board or Commission First Choice:*

Select One Animal Shelter Advisory Board Arts & Humanities Commission Board of Adjustment Economic Development Advisory Board Golf Advisory Board Library Advisory Board Parks and Recreation Advisory Board Planning and Zoning Commission Rowlett Diversity, Equity and Inclusion Commission Rowlett Housing Finance Corporation Senior Advisory Board (must be 60 years or older)

Board or Commission Second Choice:*

Select One Animal Shelter Advisory Board Arts & Humanities Commission Board of Adjustment Economic Development Advisory Board Golf Advisory Board Library Advisory Board Parks and Recreation Advisory Board Planning and Zoning Commission Rowlett Diversity, Equity and Inclusion Commission Rowlett Housing Finance Corporation Senior Advisory Board (must be 60 years or older)

Are you willing to serve on a different Board or Commission than your First or Second choice?*

Yes

No

Applicant's Name:*

Home Address:*

ZIP Code:*

Preferred Phone Number:*

Email Address:*

Residency Information

Length of Residency in Rowlett:*

Are you a registered voter in Rowlett? (All members of citizen boards and commissions must be registered voters, residing in the City of Rowlett. This does not apply to Junior Alternate Members):*

Yes

No

If yes, what is your registration number:

Could your voter registration be listed under a different (i.e. legal) name than provided above? {Example: Michael for Mike, Melissa for Missy} If so, please provide.

Birthday (mm/dd/yyyy)*

Experience

Briefly describe the experiences (job related or otherwise) that have readied you for service. Include organizations, titles, dates, tasks and/or duties, etc.*

Education

Please describe your educational background, including the highest level attained and all degrees, technical training, certifications, etc. that are relevant:*

Skills and Qualifications

List any specific skills, abilities, and qualifications that are relevant to the position(s) applied for:*

Membership Information

Are you currently serving on other City Boards or Commissions?*

Yes

No

If yes, which one:

Have you served on a City Board or Commission before?*

Yes

No

If yes, which one(s):

Have you participated in any of the City's Academies (Citizen Academy, Citizen Fire Academy, Citizen Police Academy)?*

None Citizen Academy

Citizen Fire Academy Citizen Police Academy

Reason for Applying

Tell us why you want to serve on a board or commission. Please include any particular goals you have, and any talents, experiences or interests that would help make you a valuable member:*