Board Appointment Application

The Mayor and City Council believe every resident should have the chance to take part in City decisions. One way is to serve on one of the City’s advisory boards and committees. Use this form to apply. Your application goes to the City Clerk.

Please enable JavaScript in your browser to complete this form.

Which board or boards are you applying for? *

• ABC Board
• Downtown Development Board
• Keep Bessemer City Beautiful
• Parks and Recreation Advisory Board
• Planning Board / Board of Adjustment / Stormwater Board
• Any board where I am needed

Choose one or more.

Home activities you

Name *

First

Last

Home address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Best phone number *

Email *

Current occupation

Educational background

Volunteer, civic and professional activities

Why would you like to serve on this board or committee? *

What qualities make you the right candidate for this board? *

How can you positively impact the community by serving on this board? *

Signature

Type your full name as your signature *

Confirmation *

• I confirm the information in this application is true and complete.

Board applications may be public records under North Carolina law and may be shared with the Mayor and City Council.

Submit application