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2. First Name*
3. Last Name*
5. Address*
6. City
7. State
8. Zip
10. Residency*

    Do you reside in the Owasso city limits?

    1. Yes
    2. No
11. Present Employer
12. Current Position
14. Professional and/or Civic Activities
16. Education
18. Committees and Boards

    Check the boards or committees you are interested in serving. Check more than one, if you wish.

    1. Board of Adjustment
    2. Planning Commission
    3. Owasso Economic Development Authority
    4. Sales Tax Oversight Committee

    1. Capital Improvements Committee
    2. Annexation Committee
    3. Personnel Board

    1. Emergency Preparedness Volunteer
    2. Audit Committee
    3. Museum Volunteer
20. Comment
    Please describe why you are interested in serving on this board or committee. In what way do you feel you will benefit the public by serving?
22. Mail Choice

    If appointed, where do you prefer your mail to be sent?

    1. Home
    2. Business
24. Cerification
    ALL boards committees and commissions are subject to disclosure of conflicts of interest. The City Clerk's Office can supply you with complete information on the above requirements and the duties of the boards, committees and commissions. Once submitted, all information included in this application is available to the public, under the Oklahoma Open Records Act, 51 O.S. 24A.1, including the applicant's name, address, phone number, and place of employment. I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. (To indicate you agree, enter your email address below.)
26. Email Address*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field