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Survey/Form Review
Application for Appointment to a City Board/Commission
Applicant Information
First Name
Last Name
Address
City
State
Zip Code
Phone #
Email address
Employer Information
Employer Name
Business Address
City
State
Zip Code
Business Phone #
May Personal and Business information be included in publications released for public viewing?
How long have you been a resident of Ankeny?

I am interested in serving on:
Area of knowledge and/or expertise:

 
What knowledge/understanding of the Board/Commission do you have?

What experiences/activities qualify you for this position?

Why do you wish to serve on the Board/Commission?

Would you be able to attend regularly scheduled meetings?
Do you sell to, or are you in any manner a part to, any contract to furnish supplies, material, or labor to the City of Ankeny?
If yes, please list:
Have you ever been employed by the City?
If yes, please list dates of employment and positions held:
Typically new appointments will be made in January. Notification to all applicants will be completed by January 31st.

If Not selected, do you wish to have your application retained on file?
Questions? Contact Pam DeMouth, City Clerk, at (515) 965-6405