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2. Thank you for your interest in serving on a City of Monona committee. Please provide the information listed below. All information on this form is public record.
4. Name*
6. Home Address*
8. Email(s)*
10. Phone*
11. Alternate Phone
13. Employer
14. Occupation
16. Please check all committees on which you're interested in serving.*

    1. Board of Review
    2. Community Media Committee
    3. Community Development Authority
    4. Distinguished Service Award Committee
    5. Diversity & Equity Implementation Committee
    6. Facilities Committee
    7. Landmarks Commission
    8. License Review Committee
    9. Library Board of Trustees
    10. Transit Commission

    1. Parks & Recreation Board
    2. Plan Commission
    3. Police & Fire Commission
    4. Public Safety Committee
    5. Public Works Committee
    6. Senior Citizens' Commission
    7. Sustainability Committee
    8. Tourism Commission
    9. Zoning Board of Appeals
18. What education or special training do you have which you feel particularly relates to the committee(s) in which you're interested?
20. What work experience or other experience do you have which will be beneficial in carrying out the responsibilities of this committee(s)?
22. The City of Monona is committed to ensuring that the City’s boards, committees, and commissions represent a cross section of the Monona community. As such, please consider sharing as much personal information about yourself as you’re comfortable sharing. For instance, your age, sex/gender, race/ethnicity, how long you’ve lived in Monona, etc.
24. While meeting days and times are currently set for all committees, we are gathering the following data for future reference. Please tell us about your schedule. What days and times are you able to attend meetings and which do you prefer? Are virtual meetings an option for you?
26. Do you have questions or want more information regarding the committee appointment process or a specific committee?
    Link here for questions
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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