2. Please indicate which Boards or Commissions you are applying for.*

   You may apply for up to THREE, but may only be appointed to serve ONE:

   1. Board of Adjustment
   2. Board of Building Appeals
   3. Castle Rock Water Commission
   4. Design Review Board

   1. Election Commission (3 yrs)
   2. Historic Preservation Board
   3. Parks & Rec Commission
   4. Planning Commission

   1. Public Art Commission
   2. Public Safety Commission
   3. Public Works Commission
4. Please indicate your first choice preference*
5. Upload Resume (optional)
7. First Name*
8. Last Name*
9. Email address*
11. Street Address*
12. Zip Code*
13. Occupation*
15. Phone *
16. Are you a registered voter in Douglas County?*

    1. Yes

    1. No
18. In which Town district do you reside?

    If unsure, you can search by your address at CRgov.com/ElectionDistricts

    1. District 1
    2. District 2

    1. District 3
    2. District 4

    1. District 5
    2. District 6
20. Are you currently now serving on a Town Board or Commission?*

    1. Yes

    1. No
21. If Yes, please list the Board or Commission(s) and Term Expired Date(s)
23. Have you previously served on a Town Board or Commission?*

    1. Yes

    1. No
24. If Yes, please list the Board or Commission(s) and Term Expired Date(s)
26. Please indicate why you are interested in serving on a Town Board or Commission(s)*
28. What qualifications or experience do you have that would prepare you to serve as a Board or Commission member?*
30. Please indicate organizational memberships, appointments or positions held in community organizations, business associations, clubs, foundations and any volunteer activities.*
32. How did you learn of the Boards & Commission volunteer positions?

    1. Newspaper
    2. CRgov website

    1. Facebook / Twitter

    1. Town News Release

    1. Volunteer Connect
34. Boards and Commission applicants are considered for appointment regardless of race, religion, sex, age, national origin or disability. Please check each statement to affirm:
36. I understand the duties and requirements for this position. I understand that attendance at Board & Commission meetings is crucial to the success of the organization and I am aware of the meeting schedule and absence policy.*

    1. Yes
38. I understand that if I become an employee of the Town, appointed to another board or commission, or elected to Town Council, then I would be required to resign my appointment.*

    1. Yes
40. I understand that I am held accountable to the Town's Code of Conduct, and will be required to take an Oath of Office as an appointee to a Board or Commission.*

    Town's Code of Conduct

    1. Yes
42. I understand that the Colorado Public Records Law may require information within this application to be accessible to the public, except when specifically made confidential by statute.*

    1. Yes
44. By submitting this form, I confirm all information and statements on this application are accurate and truthful, and I authorize the Town of Castle Rock and its staff to verify this information .*

    1. I agree
46. Signature*

    Type full name to represent your electronic signature

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48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

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