City of Temple Terrace Customer Service

2. Your Service to the City is earnestly solicited. Service on a Board or Committee provides citizens with an opportunity to help shape policy and direction for the City of Temple Terrace.
4.  If you currently serve on a City Board or Committee, please state which Board(s):
6. Name
7. email
9. Address
11. City
12. State
13. Zip
15. Phone Number
17. Employment
19. Employer
20. How long?
22. Title/Occupation:
23. Work Phone Number:
25. Professional Qualifications and/or Work Experience:
27. Other Qualifications: Briefly describe any specific expertise and/or abilities that would pertain to your service on a City Board or Committee:
29. Community Activities/Memberships:
31. Educational Background:
33. Indicate reasons for desiring to serve:
35. Florida Statute Section 760.80 requires the City of Temple Terrace to maintain and report the following information:
37. Race
38. Gender
39. Disability
41. A resume or separate sheet with additional information may be included.
43. If the Applicant is not appointed at the next City Council meeting scheduled for the purpose of making appointments, this application will be retained on file for six months.
45. ACKNOWLEDGEMENT:
47. By filing this application with the City of Temple Terrace, I do hereby acknowledge the following: 1)This application when completed is a public record and open to public inspection. 2) Florida Law requires that members of certain Boards file a financial disclosure form. I consent to the filing of the State Form, Statement of Financial Interest (Form 1), if required by law for the position. 3) If appointed, I agree to faithfully, impartially and fully perform the duties of my office, will make every endeavor to serve my full term, and will comply with all laws or ordinances of the City, County, and State of Florida, particularly the Florida Sunshine Law.
49. Signature
50. Date
    Date
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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

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