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2. Please Note:

   Interest forms are not required to receive an appointment, nor does submitting an interest form guarantee an appointment.

   All fields are required.

4. First Name
5. Last Name
7. Phone
8. Email*
10. Address*
12. Address
14. City
15. State
16. Zip
18. Are you employed? If so, who is your employer?
20. I am interested in the following boards:

    1. Board of Park Commissioners
    2. Board of Zoning Appeals
    3. Civil Service Commission
    4. Community Improvement Corporation
    5. Community Reinvestment Housing Council
    6. Economic Development Revolving Loan Fund Committee
    7. Human Relations Commission
    8. Income Tax Board of Review

    1. Miami Shores Golf Advisory Board
    2. Planning Commission
    3. Records Commission
    4. Recreation Board
    5. Tax Incentive Review Council
    6. Miami County Board of Health
    7. Miami County Community Action Council (Miami County CAC)
    8. Miami County Metropolitan Housing Authority
22. Why are you interested on being on the above board(s)?
24. Please describe your skills and/or qualifications to serve on the above board(s):
26. Have you served on a board or commission before?

    1. No, I have not served on a city board/commission before.
    2. Yes, I have served on city board/commission before.
28. If you answered "yes" to the question above, list the name(s) of the board/commission on which you served, and dates served.
30. Do you live within the city limits of Troy?
31. Are you a registered voter?
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field