City of Deerfield Beach: Board Application

Profile

Prefix
First Name *
Middle Initial
Last Name *
Suffix

Email Address *

Street Address *
Suite or Apt
City *
State *
Postal Code *

What district do you live in? *

Primary Phone * Primary Phone
Alternate Phone Alternate Phone

Are you a year-round resident? * Yes No

If no, which months are you away?

Employer
Occupation

Employer's Address

Which Boards would you like to apply for? *

Please select a Board

Interests & Experiences

Please list any governmental Advisory Boards or Committees on which you currently serve: *

Academic: Degrees, Diplomas *

Professional: Certifications *

Knowledge: Training, interest, or experience *

Community Involvement: List organizations/positions *

Organizations: Memberships *

Upload a Resume
Please upload your resume

Certification

Please acknowledge your understanding of the following statement: *

I understand that in accordance with the Florida Sunshine Law, this information may be made public. I understand that the appointment is for voluntary, uncompensated service. If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full term and will comply with all laws and ordinances of the City, County and State of Florida, particularly those pertaining to the conduct of public officials and the financial disclosure requirements, if applicable to my position.

I Agree *