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2. Name:
4. Address:
6. City, State, Zip Code
8. Phone Number:
9. Alternate Phone Number:
11. Email:
13. Have you lived in the City of Liberty for at least one year?

    1. Yes
    2. No
15. Advisory board or commission preference #1
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
17. Advisory board or commission preferences #2
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
19. Advisory board or commission preference #3
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
21. Advisory board or commission preference #4
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
23. Advisory board or commission preference #5
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
25. Advisory board or commission preference #6
    -- Select One --Arts CommissionBoard of Zoning AdjustmentsBoard of AppealsCommunity Christmas Tree Advisory CommissionCemetery CommitteeCitizen Sales Tax Oversight CommitteeEconomic Development Sales Tax BoardFair Housing and Rehabilitation CommitteeHistoric District Review CommissionLiberty Housing AuthorityParks & Recreation BoardParks & Rec Foundation BoardPlanning & Zoning CommissionPreservation & Development CommissionPublic Safety Sales Tax Oversight CommitteeTourism CommitteeTax Increment Financing CommissionTree Board
27. Please list any relevant experience.
29. Please list any civic, professional and community activities.
31. How did you hear about this opportunity?
    -- Select One --City of Liberty WebsiteCity of Liberty NewsflashMayor BrentonCouncil Member JennessCouncil Member PhillipsCouncil Member DuncanCouncil Member PozelCouncil Member WattCouncil Member GrahamCouncil Member HaganCouncil Member GentrupCity of Liberty EmployeeOther
33. If City of Liberty Employee or other please list.
35. Please list any additional comments.
37. References (optional):
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39. 1. Receive an email copy of this form.
40. Email address

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41. Submit

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