Converge and Create

Board/Committee Application

Please complete this form if you are interested in serving on one of the City's Boards and/or Committees.

Your Full Name:
Your Current Mailing Address:
Your Current Street Address (if different than mailing):(optional)
Enter Your Phone Number:
Please Enter an Alternate Phone Number:(optional)
How long have you been a Waterville resident?
Your Occupation:
Please indicate which Boards/Committee you would like to be a member of:
Are you currently employed by the City full or part-time?
Please list your interests/skills that would benefit the committee(s) you indicated;
Please state why you wish to serve on a board/committee:
Please list one reference:
Please Enter a Phone number for Your Reference:
By typing your full name below you are signing this document and verifying all information entered is true:
Date Signed:
Would you would like confirmation that this form has been received? Please indicate below:
Your Email Address:(optional)
Please enter the security code below: