Board and Commission Application

2. Please complete the online form below.
4. Personal Information
6. Name:*
8. Home Address:*
10. Mailing Address:*
12. City:*
14. State:*
16. Zipcode:*
18. Inside City Limits:*

    1. Yes
    2. No
20. Home Phone Number:*
22. Cell Phone Number:*
24. Occupation:*
26. Employer:
28. Email Address:*
30. Residency Information
32. Number of years as a Midlothian resident:*
34. Are you a registered voter:*

    1. Yes
    2. No
36. Voter registration number:
38. Board and Commission Choices
40. Please select your preferences from the list:*

    1. Historic Advisory Board
    2. A.H. Meadows Library Board (joint with the school district)
    3. Midlothian Community Development Corporation (4B)
    4. Midlothian Development Authority (MDA)
    5. Midlothian Economic Development (4A)
    6. Mid-Way Airport Board (joint with Waxahachie)
    7. Park Board
    8. Planning & Zoning Commission
    9. Utility Advisory Board
    10. Zoning Board of Adjustments
42. Organization Membership Information
44. Are you currently serving on other Boards, Commissions, or Committees?*

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

    1. Yes
    2. No
50. If yes, which:
52. Please list organization memberships and positions held:
54. Please describe any special knowledge, qualifications or expertise that relates to your possible appointment:
56. Are you, or a member of your family, involved in any business transaction with the City of Midlothian?*

    1. Yes
    2. No
58. If yes, please explain:
60. Please give a brief statement why you would like to be appointed to a Board or Commission.
62. Recognizing that serving on a Board or Commission is often time consuming, most meet on a monthly basis, are you committed to attending all regulary scheduled meetings?*

    1. Yes
    2. No
64. Please Note: All appointments are made at the discretion of the City Council. While there is no guarantee of an appointment, all applications will be considered equally. Applications will be kept on file for one year and then either updated or withdrawn by the applicant.
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66. Submit Submit and Print

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