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Committee Volunteer Form

2. Date*
   Date

4. First Name*

5. Last Name*

7. Address*

9. City*

10. State*

11. Zip*

13. Email*

14. Phone*

16. Place of Employment

18. How long have you been a resident of Roeland Park?

19. How much time do you have to devote per month?

21. Board & Committee Interest*

    Briefly describe why you are interested in serving on a board or committee for the City of Roeland Park.

23. Select a Board or Committee*

    Please select which board or committees you are interested in serving on (only one per application).

    1. Arts
    2. Board of Zoning Appeals
    3. Community Foundation
    4. Community Engagement
    5. Parks
    6. Planning Commission

    1. Aquatic Advisory Committee
    2. Sustainability
    3. Youth Advisory Council
    4. Ad-Hoc Development Committee
    5. Other
25. Additional Comments

    Please provide any additional comments, if any.

27. Resume

    Please provide a copy of your resume.

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field