Form Center

3. 
7. ALL INFORMATION ON THIS APPLICATION WILL BECOME PUBLIC RECORD.
11. NAME*
13. HOME ADDRESS*
14. CITY*
15. STATE*
16. ZIP*
18. MAILING ADDRESS*
19. CITY*
20. STATE*
21. ZIP*
23. PREFERRED DAYTIME PHONE*
24. PREFERRED NIGHT TIME PHONE*
26. EMAIL ADDRESS*
28. 
    
30. PERSONAL REFERENCES
32. Name*
33. Name*
34. Name
36. Address*
37. Address*
38. Address
40. Daytime Phone #*
41. Daytime Phone #*
42. Daytime Phone #
44. Do you live in Kemah?*

    1. YES
    2. NO
45. How long?*
    -- Select One --BLANKN/ALess than 1 Year1 - 2 Years3 - 5 Years5 - 10 YearsMore than 10 Years
47. Do you live in Galveston County?*

    1. YES
    2. NO
48. How long?*
    -- Select One --BLANKN/ALess than 1 Year1 - 2 Years3 - 5 Years5 - 10 YearsMore than 10 Years
50. 
    
52. If you have been a member of the Kemah Community Development Corporation before, please indicate the approximate dates of service*
54. Why do you want to serve on KCDC?*
56. What experience do you have that may qualify you for service on the Kemah Community Development Corporation (i.e. licenses, degrees, and certifications)?*
58. Please list any civic or community endeavors in which you have been involved*
60. 
    
62. I understand that applications for KCDC positions will be interviewed by City Council. I will be contacted by the City Secretary’s Office for an interview date and time.
64. 
    
66. I understand that if appointed, I must adhere to Ordinance No. 1101, which requires all members of the City
    Council and the Kemah Community Development Corporation (KCDC) to complete a disclosure statement within
    30 business days of appointment.
68. (See attached)
    Ordinance 1101
70. 
    
72. I understand that State law requires that I undergo one hour of training concerning the Open Meetings Act within
    90 days of my appointment.
74. 
    
76. I hereby affirm the information herein is true and correct to the best of my knowledge.
78. 
    
80. Signature*
82. Date*
84. Please attach cover letter*
86. Please attach résumé*
Leave This Blank:


87. Submit Submit and Print

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