Volunteer Interest

Board/Commission Volunteer Interest Form

Occasionally the City of Nixa has openings on any of its boards, commissions, or committees. All such roles are voluntary and some come with particular requirements such as an even distribution of members across the city's three council districts. In order to be considered to fill any such vacancies, please complete the following form. Upon submission, your name will be added to a list of potential candidates to be considered for voluntary public service on whichever board, commission, or committee may have a vacancy.

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Which council district do you currently reside in?

District 1

District 2

District 3

Unsure

How many years have you lived inside Nixa city limits?

Describe any prior experience on any City of Nixa board, commission or committee

Describe any prior experience volunteering for or working any paid job for the City of Nixa or any other municipal or county government

Describe your career, industry, degrees, certifications, and major professional achievements

Describe your schedule availability

Most of our board/committee meetings are held in the evenings once or twice each month. Some special committees may need to meet on a weekly basis over a short period of time in a temporary capacity.

Describe why you would like to be considered for a public service opportunity on a city board/commission/committee

Are you related to any current or former employee of the City of Nixa or are you related to any current or former Nixa elected official?

Yes

If you answered Yes, who are they?

This may disqualify you from serving on certain boards/commissions/committees, but relatives of employees and former elected officials may be allowed to serve on other committees.

First Last

Preferred volunteer position

If there is a particular board/commission/committee on which you are hoping for an opportunity to serve, enter the name of that board/commission/committee below

Willingness to serve in other positions

If your preferred board/commission/committee does not currently have open seats, or if you are not selected to fill whichever seat is currently available, are you willing to serve in a different capacity or be considered again in the future?

Yes

Phone

This field is for validation purposes and should be left unchanged.

34114

Volunteer Interest

Board/Commission Volunteer ﻿Interest Form

Board/Commission Volunteer Interest Form