PROFILE

PROFILE

Name (First/MI/Last):

Email Address:

Home Address:

PROFILE

Phone Number:

Are there any special accommodations needed?

Are there any special accommodations needed?

Yes

No

If yes, please list anything we can help with: Translation services, Hearing or ADA Accommodations

If yes, please list anything we can help with: Translation services, Hearing or ADA Accommodations

EDUCATION

EDUCATION

Dates:

Location (City State):

School Name:

WORK EXPERIENCE

WORK EXPERIENCE

Dates:

Employer

Job Title

Address (Street, City, State)

WORK EXPERIENCE

Duties:

INTERESTS AND EXPERIENCES

Please tell us about yourself and why you want to serve. 

Why are you interested in serving on the Junior City Council?

JOB SPECIFIC SUPPLEMENTAL QUESTIONS 

Are you a City of Wenatchee resident?

JOB SPECIFIC SUPPLEMENTAL QUESTIONS Are you a City of Wenatchee resident?

Yes

No

Have you previously served on a City of Wenatchee Board, Commission or Committee?

Have you previously served on a City of Wenatchee Board, Commission or Committee?

Yes

No

If yes, please explain which.

If yes, please explain which.

Please list any experience that would assist you in serving on the Junior City Council.

Please list any experience that would assist you in serving on the Junior City Council.

Please list any experience that would assist you in serving on the Junior City Council.

Please list your professional activities that relate to this position.

Please list your community activities that relate to this position.

Are you related to any elected City official or staff member?

Are you related to any elected City official or staff member?

Yes

No

If yes, please provide the name of the City official or staff member, as well as your relationship.

If yes, please provide the name of the City official or staff member, as well as your relationship.

Do you or any of your family members work for, or serve on, the board of directors of any organization which has contracted with or applied for funding from the City of Wenatchee?

Do you or any of your family members work for, or serve on, the board of directors of any organization which has contracted with or applied for funding from the City of Wenatchee?

Yes

No

If yes, please describe the relationship.

If yes, please describe the relationship.

Are you involved in any personal, professional, or business pursuit that would affect your ability to make fair and impartial recommendations/decisions as a member of a City citizen advisory committee?

Are you involved in any personal, professional, or business pursuit that would affect your ability to make fair and impartial recommendations/decisions as a member of a City citizen advisory committee?

Yes

No

Are you able to attend daytime meetings?

Are you able to attend daytime meetings?

Yes

No

Are you able to attend evening meetings?

Are you able to attend evening meetings?

Yes

No

Reference #1: Please list a non-relative reference who can provide reliable information about you. Please be sure to list the following information: name, relationship to you, phone number, and email address.

Reference #1: Please list a non-relative reference who can provide reliable information about you. Please be sure to list the following information: name, relationship to you, phone number, and email address.

Reference #2: Please list a non-relative reference who can provide reliable information about you. Please be sure to list the following information: name, relationship to you, phone number, and email address.

Reference #2: Please list a non-relative reference who can provide reliable information about you. Please be sure to list the following information: name, relationship to you, phone number, and email address.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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