Citizen Board Application

All fields marked with an asterisk (*) are required.

Contact Information
Name*
First Middle Last
Phone*
Email*
Enter Email Confirm Email
Home address*
Street Address Apartment, suite, unit, building, floor, etc. City State ZIP Code
Business address
Street Address Apartment, suite, unit, building, floor, etc. City State ZIP Code
Your Requested Board(s)
Please list in order of your preference, the board(s) for which you are submitting this application and the special skill(s) that would be beneficial in serving on said board.
Board (First)*
Skills*
Board (Second)
Skills
Board (Third)
Skills
Your Requested Commission Member
Each applicant can request consideration of appointment by a specific member of the City Commission. Please select one option:
Option*
- I would like my application to be considered by a specific member of the Commission.
- I would like my application to be considered by the entire City Commission. I do not have a preference for a specific commission member.
Please read carefully before selecting this board. All information provided will be kept confidential.
Section 760.80, Florida Statutes, states the intent of the Legislature to recognize the importance of balance in the appointment of minority and nonminority persons and persons with physical disabilities to statutorily created decision making and regulatory boards, commissions, councils, and committees.
The Statute requires the City to submit annually the Report of Minority and Physically Disabled Appointments. This report discloses the number of appointments made from each minority and non-minority group and the number of physically disabled persons appointed in the prior calendar year. For this purpose, minority persons are defined as below. In order to comply with this requirement, please select the appropriate options below.
City Commision Member*
Race*
- African American: a person having origins in any of the racial groups of the African Diaspora.
- Asian American: a person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands, including the Hawaiian Islands prior to 1778.
- Hispanic American: a person of Spanish or Portuguese culture with origins in Spain, Portugal, Mexico, South America, Central America, or the Caribbean, regardless of race.
- Native American: a person who has origins in any of the Indian Tribes of North America prior to 1835.
- Caucasian
- Decline to Identify
Gender*
- Male
- Female
- Decline to Identify
Physically disabled?*
- Yes
- No
Your Details
Are you a registered voter?*
- Yes
- No
Are you a resident of the city?*
- Yes
- No
Do you own property in the city?*
- Yes
- No
Are you employed by the City?*
- Yes
- No
May we automatically submit your application when vacancies occur?*
- Yes
- No
Do you have any potential conflicts of interest that may arise from time to time if you serve on one of these boards?*
- Yes
- No
Please explain*
Are you currently serving on a City board(s)?*
- Yes
- No
Please specify which board(s)*
- Board of Adjustments
- Civil Service Board
- Code Compliance Board
- Community Redevelopment Advisory Board
- Construction Board of Adjustments & Appeals
- Economic Development Advisory Board
- Golf Course Advisory Board
- Historic Preservation Board
- Housing Authority Board
- Keep Winter Park Beautiful & Sustainable Advisory Board
- Lakes & Waterways Advisory Board
- Parks & Recreation Advisory Board
- Planning & Zoning Board
- Public Art Advisory Board
- Transportation Advisory Board
- Tree Preservation Board
- Utilities Advisory Board
- Winter Park Firefighters’ Pension Board
- Winter Park Police Officers’ Pension Board
Have you previously served on a City board(s)?*
- Yes
- No
Please specify which board(s)*
- Board of Adjustments
- Civil Service Board
- Code Compliance Board
- Community Redevelopment Advisory Board
- Construction Board of Adjustments & Appeals
- Economic Development Advisory Board
- Golf Course Advisory Board
- Historic Preservation Board
- Housing Authority Board
- Keep Winter Park Beautiful & Sustainable Advisory Board
- Lakes & Waterways Advisory Board
- Parks & Recreation Advisory Board
- Planning & Zoning Board
- Public Art Advisory Board
- Transportation Advisory Board
- Tree Preservation Board
- Utilities Advisory Board
- Winter Park Firefighters’ Pension Board
- Winter Park Police Officers’ Pension Board
List any other community involvement
List any work/career experience
List your educational experience
Comments
This field is for validation purposes and should be left unchanged.

Contact Information

Your Requested Board(s)

Your Requested Commission Member

Please read carefully before selecting this board. All information provided will be kept confidential.

Your Details