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Commissions & Committees Application

4. Select the Commission or Committee applying for*
   -- Select One --Select OneAppeals and Variance Hearing OfficerSpecial Event Arena CommitteeDiversity and Inclusion Advisory CommitteeEmergency Preparedness CommitteeHistoric Preservation CommissionMayor's Youth Council Advisory CommitteeParks, Trails and Recreation CommitteePlanning CommissionTree Committee
6. Personal Information
8. First Name*
9. Last Name*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Home Phone Number*
21. Business Address*
23. Business Phone Number*
25. Occupation*
27. Email Address
29. Residency Information
31. Length of Residency in Draper City*
33. Are you a registered voter*

    1. Yes
    2. No
35. Education and Hobbies
37. High School
39. College
41. Trade or Business School
43. Hobbies
45. Organization Membership Information
47. Are you currently serving on other Commissions or Committees?*

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

    1. Yes
    2. No
53. If yes, which
55. Please list organization memberships and positions held
57. Please List Areas of Special Interest
59. Please Enter Basic Resume Information Below
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit Submit and Print

* indicates a required field