Consent and Willingness to Serve on a

Board or Commission

First and Last Name:
Phone Number
Physical Address:
Mailing Address If different from Physical Address
Email Address:
Briefly describe your interest and qualifications for the position desired:
List any civic or community endeavors in which you have been involved:
Appointed Position Desired: Select all boards for which you are interested in serving:

Do you wish to re-apply for a position in which you have been previously appointed?
Have you served on the Alvin City Council?
Have you served on an Alvin City Board, Commission, or Committee?
How many years have you been a resident of Alvin?
How long have you been a resident of Texas?
Are you a registered voter?
Date of Birth: mm/dd/year
I understand that appointments are soley at the discretion of city council and that this form is not the only basis of candidate selection. If appointed, I will accept the position and faithfully serve to the best of my ability. I understand that the information provided in this document may be subject to the Public Information Act.
Typed Signature
Date Submitted mm/dd/year

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Alvin City Hall
216 West Sealy
Alvin, Texas 77511

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Monday through Thursday - 7:00 AM to

6:00 PM
Closed: Friday, Saturday, and Sunday

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