Application for Appointment to City Boards and Commissions

All information with * next to it must be provided. Incomplete applications will not be processed.

Name of Board(s) or Commission(s)*

Full Name*

Address*

City State Zip*

Occupation

Employer

18 Years of Age or Older? (Yes/No)

Home Phone*

Business Phone*

Cellular Phone

Email Address

Do you currently reside / live within the Oshkosh City Limits?

Number of Years

Education

Do you have any relatives in the service of any department of the City of Oshkosh? (Yes/No)

List name, department and relationship

List any potential conflicts of interest

List City boards, commissions or committees on which you have served

Name

Years

Name

Years

Name

Years

Name

Years

Name

Years

Name

Years

What previous education, experience, training, or other special qualification from your background do you feel qualifies you for the position(s) you are interested in?

If selected, how would you work towards bettering the community through service on the Board/Commission?