Appointment to City Board Application

Home » Government » Appointment to City Board Application

Print Out and Mail your Application for Appointment.

Click here to download PDF application

Your Name:

First Middle Last

Your Phone #:

Your Address:

Street Address City State ZIP Code

Employer:

Title/Occupation:

Employer Phone #:

Employer Address:

Street Address City State ZIP Code

At which address would you prefer to be contacted?:

Home

Work

Are you a Registered voter of the city of Fort Pierre?:

Yes

Are you a Resident of the city of Fort Pierre?:

Yes

I would like to serve on the following:

Please rank if selecting more than one.

Please list education or training relevant to your choice(s):

Please list work experience relevant to your choice(s):

Please list community volunteer service relevant to your choice(s):

I would like to serve in the indicated position(s) because:

The following reference may be contacted.

Name:

First Last

Address:

Street Address City State ZIP Code

Phone:

Name:

First Last

Address:

Street Address City State ZIP Code

Phone:

Please upload your resume and/or brief autobiography:

Max. file size: 128 MB.

Signature:(Required)