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Date of Birth is necessary to conduct the criminal background check.
Please provide a brief summary of your employment history for the last 10 years, beginning with your current or most recent employer: If retired, please indicate previous employment. Be sure to include Occupation, Employer and Dates of Employment(Month/Year)
The City of Holland is committed to the implementation of the Americans with Disabilities Act. Please contact the City Manager’s Office via email at firstname.lastname@example.org with any special needs or accommodations.
Because serving on a board, commission or committee requires a substantial commitment of time, effort, and scheduling on the part of the members, we ask that you carefully consider your schedule before pursuing appointment to a board, commission, or committee and that by signing below you are confirming your willingness to make a concerted effort to attend every meeting and to fulfill your duties and responsibilities as a member. All information submitted in this application is public information and subject to disclosure in response to a public records request made pursuant to the Freedom of Information Act.
I certify that all statements on this Board, Commission, or Committee application are made truthfully and without evasion, and further understand and agree that such statements may be investigated and, if found to be false, will be sufficient reason for not being appointed.
I understand that a criminal background check must be completed and passed before being accepted as volunteer and that said information will be kept confidential.
The information on this application will be treated in a confidential manner by the City of Holland. However, appropriate information will be reviewed by the City Council prior to an appointment being approved.
This field is not part of the form submission.
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