Citizen Committee Interest Form

2. Contact Information

4. First Name*

5. Last Name*

7. Address1*

9. City*

10. State*

11. Zip*

13. Phone Number*

15. Email Address*

17. I Am Interested In Serving On The Following Board(s)

    1. Board of Ethics
    2. Brownfields Advisory Committe
    3. Building Board of Appeals
    4. Cemetery Commission
    5. Citizen Advisory Committee
    6. Committee on Aging
    7. Community Development Authority
    8. Crime Prevention Committee 
    9. Harbor Commission
    10. Industrial Development Corporation

    1. Library Board
    2. Manitowoc International Relations Association 
    3. Manitowoc Public Utilities Commission
    4. Municipal Tree Commission 
    5. Plan Commission 
    6. Police and Fire Commission
    7. Rahr-West Art Museum Board 
    8. Transit Commission
    9. Zoning Board of Appeals 
19. Length of Residency in the City of Manitowoc

21. Current Occupation

23. Business Name

25. Business Segment (Manufacturing, Retail, etc.)

27. Past and Current Community Service

29. Are you currently serving on other Boards, Commissions or Committees?*

    1. Yes
    2. No

31. If yes, which

33. Education Information

35. Background/Experience

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field