2. Application for Appointment

   For volunteering to serve on a Board or Commission.

   Please note that information provided on this application form is subject to Chapter 42.56 RCW: Public Records Act. If recommended for appointment, your application will be submitted to the City Council in the public agenda packet.

4. Boards & Commissions*
   -- Select One --Affordable Housing CommissionArts CommissionCivil Service CommissionDiversity, Equity, and InclusionEnvironmental CommissionLandmarks and Design CommissionLEOFF 1 Disability BoardLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionEllensburg Transportation Advisory CommitteeUtility Advisory Committee
6. Have you attended a meeting for the board or commission you are applying to?*
   -- Select One --YesNo
8. Name of Applicant:*
10. Address*
12. Mailing Address (If Different)
14. City*
15. State*
16. Zip*
18. Email Address*
19. Phone Number*
21. Length of Residency in Kittitas County*
22. Do you live within the city limits?*

    1. Yes

    1. No
24. ECC 1.12.120 Residency qualification. Except where a commission, board or committee specifically requires city residency as a condition of appointment, members of all other commissions, boards and committees shall maintain residency within the Kittitas County limits. “Residency,” as used herein, means residing within the city or county limits, as applicable, both at the time of appointment and for at least 270 days within each calendar year for the duration of the member’s term, but shall not include any period for which a member is absent due to military service.
26. Occupation Status and Background:*
28. Organization Affiliations:*
30. Why are you seeking appointment?*
32. Will you be able to attend meetings regularly if appointed?*

    1. Yes

    1. No
34. If your first choice, as listed above, is not available, which other boards or commissions would you be interested in serving on?
36. Boards & Commissions
    -- Select One --Affordable Housing CommissionArts CommissionCivil Service CommissionDiversity, Equity & InclusionEnvironmental CommissionLandmarks and Design CommissionLEOFF 1 Disability BoardLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionEllensburg Transportation Advisory CommitteeUtility Advisory Committee
38. Boards & Commissions
    -- Select One --Affordable Housing CommissionArts CommissionCivil Service CommissionDiversity, Equity & InclusionEnvironmental CommissionLandmarks and Design CommissionLEOFF 1 Disability BoardLibrary BoardLodging Tax Advisory CommitteeParks and Recreation CommissionPlanning CommissionEllensburg Transportation Advisory CommitteeUtility Advisory Committee
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field