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2. Name
4. Address
6. Contact Number
8. Email
10. Please indicate which Board, Commission or Committee you are interested in serving on.*

    I would like to serve on:

    1. Board of Adjusment
    2. Board of Appeals
    3. Civil Rights Commission
    4. Civil Service Commission
    5. Complete Streets
    6. Economic Development Advisory Board
    7. Library Board of Trustees
    8. Parks & Recreation Commission
    9. Planning & Zoning Commission
    10. Public Art Committee
    11. Tree Board
    12. Urbandale Sanitary Sewer District
    13. Urbandale Windsor Heights Sanitary Sewer District
12. Please list your qualifications:
    List your educational and professional experience, and/or your biographical information that would help you succeed as a member of the Board, Commission or Committee
14. The City of Urbandale encourages diversity in the appointment to boards and commissions.
16. Thank You!
    Your completed form will be sent to the City Clerk. The Clerk's office can be contacted at 515-278-3900.
17. Next Steps.
    The Mayor reviews applications of interest when a Board, Commission or Committee has an opening. This could be either due to a member's term expiring or due to a member stepping down early.
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19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field