Thank you for your interest in serving on the Homelessness Solutions Task Force.   

Please complete the form below and click the "Submit" button at the bottom of the page.  Someone from the City Manager's office will be in touch.

1

List the stakeholder group you wish to represent.  Please choose all that apply:

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List the stakeholder group you wish to represent. Please choose all that apply:

Local school district

The business community

The homeless community

Veterans

2

Name:

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Name:

3

Address:

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Address:

4

Telephone Number:

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Telephone Number:ext.

5

Email Address:

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Email Address:

6

Occupation:

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Occupation:

7

Employer:

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Employer:

8

Why do you think you are qualified to be a Committee member?

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Why do you think you are qualified to be a Committee member?

9

State your educational background.

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State your educational background.

10

Have you ever served on a community committee?  If so, what kind?

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Have you ever served on a community committee? If so, what kind?

11

Do you agree with consensus decision making?

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Do you agree with consensus decision making?

12

Are you willing to attend regularly scheduled meetings of the task force?

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Are you willing to attend regularly scheduled meetings of the task force?

13

Do you anticipate having many conflicts of interest that may disqualify you in making decisions, due to personal and/or business relationships?

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Do you anticipate having many conflicts of interest that may disqualify you in making decisions, due to personal and/or business relationships?

14

List any private and non-profit affiliations.

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List any private and non-profit affiliations.

15

List all other pertinent information/background for this position.

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List all other pertinent information/background for this position.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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