Boards and Commissions Application
If you are a resident of the City of Salisbury, at least 18 years old, and willing to volunteer your time and
expertise to your community, you are eligible for a position on a City board or commission.
Primary Contact Information
First Name
*
Last Name
*
E-mail
*
Home Phone
*
Fax
Business Phone
Address
*
City
*
State
*
Please Select
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DE
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IN
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KS
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MT
NE
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NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
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ZIP Code
*
Ethnicity
*
Asian or Pacific Islander
African American
American India/Alaskan native American
Hispanic
Caucasian/Non-Hispanic
Unknown
Prefer not to answer
Other
Ethnicity (Other):
Gender
*
Female
Male
Nonbinary or third gender
Prefer not to self-describe
Prefer not to answer
Place of Employment
Occupation
Do you reside within the City limits of Salisbury?
Yes
No
Are you within the City’s Extraterritorial Jurisdiction (ETJ) area?
Yes
No
Please indicate your #1 preference:
*
Please Select
Alternate Methods of Design Commission
Bell Tower Green Committe
Community Appearance Commission
Greenway Committee (No Requirement of Residency)
Historic Preservation Commission
Housing Advocacy Commission
Human Relations Council
Hurley Park Advisory Board
Parks and Recreation Advisory Board
Planning Board
Public Arts Commission
Tree Board
Transportation Advisory Board (No Requirement of Residency)
Other
View the Boards and Commissions webpage in a new window.
Please indicate your #2 preference:
Please Select
Alternate Methods of Design Commission
Bell Tower Green Committe
Community Appearance Commission
Greenway Committee (No Requirement of Residency)
Historic Preservation Commission
Housing Advocacy Commission
Human Relations Council
Hurley Park Advisory Board
Parks and Recreation Advisory Board
Planning Board
Public Arts Commission
Tree Board
Transportation Advisory Board (No Requirement of Residency)
Other
Please indicate your #3 preference:
Please Select
Alternate Methods of Design Commission
Bell Tower Green Committe
Community Appearance Commission
Greenway Committee (No Requirement of Residency)
Historic Preservation Commission
Housing Advocacy Commission
Human Relations Council
Hurley Park Advisory Board
Parks and Recreation Advisory Board
Planning Board
Public Arts Commission
Tree Board
Transportation Advisory Board (No Requirement of Residency)
Other
Have you served on a board or commission of the City of Salisbury?
*
Yes
No
Please list the board or commission:
Please list the date of service:
-
Month
-
Day
Year
Date
Why are you interested in serving on the Board or Commission for which you are applying?
Interest/Skills/Education/Areas of Expertise/Professional Organizations that you feel would be of assistance to you in your duties as a member of the Board or Commission:
Affirmation of Eligibility
Has any formal charge of professional misconduct ever been sustained against you in any jurisdiction?
*
Yes
No
If yes, explain complete disposition:
Is there any possible conflict of interest or other matter that would create problems or prevent you from fairly and impartially discharging your duties as an appointee of the Salisbury City Council?
*
Yes
No
If yes, explain conflict:
Serving on one of the City of Salisbury’s Boards and Commissions requires a commitment of time. Members are expected to attend the regularly scheduled Board or Commission meetings. Please give careful consideration to the meeting schedules to determine which Board or Commission may best suit your schedule and abilities.
I certify that the facts contained in this application are true and correct to the best of my knowledge. I understand and agree that any misstatement will be cause for my removal from any board or commission.
*
I agree
I disagree
Applications will remain active for one year from date of receipt.
Submit
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