You must have JavaScript enabled to use this form. APPLICANTS MUST HAVE LIVED IN THE CITY LIMITS FOR AT LEAST THE LAST 12 MONTHS AND BE A REGISTERED VOTER IN THE CITY OF HUTCHINS. YOU ARE NOT ELIGIBLE TO APPLY IF YOU DO NOT MEET BOTH OF THOSE REQUIREMENTS. Board or Commission you wish to serve: Atwell Public Library Board Economic Development Corporation Parks and Recreation Board TIRZ - Tax Increment Financing Zone Keep Hutchins Beautiful Advisory Board Building and Standards Commission Historical Society Board Planning and Zoning Board Planning and Zoning Commission Zoning Board of Adjustment Name Honorific Honorific - None -MissMsMrMrsDrOther… Enter other… First Middle Initial Last Home Address Address Address Line 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Home Phone Number Cell Phone Number Email Address How many years have you resided in the City? Are you a Qualified Registered Voter? Yes No Do you, your spouse, or your employer have any financial interest (direct or indirect) in the following? 1) In any contract with the City of Hutchins; 2) Regarding the sale of land, materials, supplies, or services to the City of Hutchins; or 3) In matters that might come before the Board/Committees to which you are seeking appointment? Yes No If yes, please explain: Please list any education, experience, or special knowledge that qualifies you to serve: List any civic or community activities in which you have been involved: Have you, or are you, currently serving, on another Board or Commission? Yes No If yes, please list and include approximate dates of service: Are you an existing Board/Commission member desiring to remain on the same board? Yes No Do you have knowledge regarding the Board/Commission you are applying to serve? Yes No Have you attended a City Council meeting before? Yes No Have you attended a Board or Commission meeting for which you have applied? Yes No PUBLIC INFORMATION NOTICE Certain information submitted on the Boards and Commission Application is subject to the Texas Information Act and may be disclosed to anyone requesting this information. The act allows a board member of a governmental body to choose whether to allow public access to the information in the custody of the city that relates to the home address and phone numbers. I, applicant for Boards/Commissions for the City of Hutchins, elect to: ALLOW public access to my home address and telephone number(s). DO NOT ALLOW public access to my home address and telephone number(s). By typing my name below and submitting the form, I acknowledge the following:All individuals appointed to serve on a board/commission will be required to complete member orientation and one hour of training relative to the Texas Open Meetings Act & Texas Public Information Act. I have read and understand the instructions and the appointment process. I certify the answers I have provided are true and correct to the best of my knowledge and belief, and I acknowledge that any misrepresentation or omission of fact may result in disqualification from service. Signature This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Leave this field blank Print
