I am interested in serving on the following committees, boards, commissions or authorities
(select up to three committees)
Date of Application (Required. mm/dd/yyyy)
(If you do not have an email address, please type "none".)
Residential street address including city and ZIP Code. (required)
(Do not enter a P.O. box.)
Home Mailing Address
(If different from above.)
How many years have you lived or worked in Tacoma?
Employer name and address
Date of Birth
Please contact me at the following phone number.
Please contact me at the following address.
The City of Tacoma promotes cultural and ethnic diversity on citizen committees, boards, commissions, and authorities. Information in this section will assist in achieving this goal and is voluntary.
Hispanic or Latino
Native American/Alaskan Native
Native Hawaiian or other Pacific Islander
City of Tacoma Council District (required.)
(If you do not know your Council District, use the following link to identify your district.) Council Districts
Outside City limits
(If retired, please indicate former occupation or profession.)
Are you or have you been a member of the Armed Forces of the United States?
Dates of Service
Branch of Service
Date and Type of Discharge
Please list any community activities that relate to this position. (required)
List any experience that would assist you in serving on this committee, board, commission,
or authority. (required)
Do you or any of your family members work for or serve on the board of directors of any
organization which has contracted with or applied for funding from the City of Tacoma?
Do you anticipate any involvement of this kind in the future? If yes, please describe the
Are you related to any elected City official or staff member? If yes, please explain. (required)
Please indicate any activities you are involved with that may present a conflict of interest with the
committee, board, commission, or authority you are applying for. (required)
Why are you interested in serving on this committee, board, commission, or authority? (required)
Please List References
Reference 1 Name
Reference 1 Daytime Phone
Reference 2 Name
Reference 2 Daytime Phone
Authorization for reference check. (required)
I hereby authorize the City of Tacoma to conduct a reference check by contacting the individuals listed above. Background Checks may be requested, with written authorization.
How did you hear about the vacancy on this committee, board, commission, or authority? (required)
City Council Member
City of Tacoma Press Release
City of Tacoma Staff
City of Tacoma Website
Friend or Co-Worker
If other was selected, please describe here.