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