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Board/Commission Application Form

2. Select the Board or Commission applying for*
   -- Select One --Select OnePlanning CommissionBuilding & Zoning Board of AppealsUrban Forestry CommissionCommission on InclusionParks and Recreation Advisory BoardSenior Citizens CommissionCivil Service CommissionIncome Tax Board of ReviewCemetery BoardArts CommissionSummit County Board of HealthRecords CommissionSummit Metro Regional Transit Authority Board
3. Date
   Date
5. Personal Information
7. First Name*
8. Last Name*
10. Address1*
12. Address2
14. City*
15. State*
16. Zip*
18. Phone Number*
19. Email Address
21. Which ward do you reside in?*
    -- Select One --1234
22. Length of Residency in Stow*
24. Have you ever been arrested or fined more than $25? (Other than minor traffic offenses)*

    Please check one

    1. Yes
    2. No
26. If yes, please explain briefly*
28. Business Address*
30. Business Phone Number*
31. Occupation*
33. Education and Hobbies
35. High School
37. College
39. Trade or Business School
41. Hobbies
43. Organization Membership Information
45. Are you currently serving on other Boards or Commissions?*

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

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


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit Submit and Print

* indicates a required field