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Community Service Application

Which Board or Commission are you interested in applying for?

If asked, would you be willing to serve on another Board or Commission:

Name:

Home Address:

Home Phone:

Work Phone:

E-mail Address:

Are you a Bellevue resident?

Yes
No

Length of residency:

1. List your educational background.

2. Please state your occupational background, beginning with your current occupation and employer.

3. Describe your involvement in the Bellevue community.

4. Describe your leadership roles and/or any special expertise you have which would be applicable to the position for which you are applying.

5. Describe why you are interested in serving in this position.

6. Appointment to this board, commission or advisory committee will require your consistent attendance at regularly scheduled meetings.

  • Are you available for evening meetings?
    Yes
    No
  • Are you available for daytime meetings:
    Yes
    No

  
Contact Information

City Clerk's Office
450 110th Ave. NE
P.O. Box 90012
Bellevue, WA 98009-9012
Phone: 425-452-6466
Fax: 425-452-2734
E-mail: mmurphy@bellevuewa.gov