Boards and Commissions Application

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Please correct the field(s) marked in red below:

 Personal Contact Information:
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Personal Contact Information:
 
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 Work Information:
Work Information:
 
 
Select Board / Commission from Drop Down List below:*
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* Loveland Utilities Commission application requires a separate financial disclosure form [Section 2.14.010(M)]
* Planning Commission application requires a separate financial disclosure form [Section 2.14.010(L)]
Do you live within the City Limits?*
Do you live within the City Limits?*
If you do not live within the City limits, describe your "substantial ties" within the City, which ties may include property ownership, employment, or conducting a business or profession within the City.
Do you currently serve on a board / commission?
Do you currently serve on a board / commission?
If Yes, what board / commission?
An individual may not serve on more than one board or commission at a time unless: 1) the member is the only qualified applicant for the position, or, 2) the member resigns his or her position on the first board or commission prior to or upon appointment to the second board or commission.
Length of Loveland area residency:
If you are applying for the Community Marketing Commission, describe any background or experience you have in the fields and business of lodging, tourism, the arts, marketing, economic development or community development.
What special education, skills or experience do you bring to the board or commission that contributes to its mission?
What days of a typical month will you be unable to attend meetings?
Will you be able to serve the complete term?
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Will you be able to serve the complete term?
Are you involved in any activities that might create a conflict of interest?*
Are you involved in any activities that might create a conflict of interest?*
If yes, explain:
List up to three personal references (not relatives) who can speak to your qualification to serve.
Name E-Mail address Phone number
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List employment history during past 10 years--include employer, address, dates and position held.
I hereby submit my application for the position indicated. I understand that the City will verify information contained herein and may make other inquiries which it deems appropriate to consideration of my application, and I consent to such inquiries. I understand I am NOT insured by Workers Compensation Insurance. I understand that I AM covered by an Accident Medical Insurance Policy with a limit of $15,000 per incident and I ACCEPT this as the limit of City liability while I am a volunteer with the City of Loveland. I hereby release the City of Loveland, its officers, employees and agents from any and all claims, damages and liability, including any claims of personal injury and property damage arising from my participation in the Volunteer program. I am submitting this application voluntarily and understand that the City of Loveland is subject to the Colorado Open Records Act, C.R.S. Sec. 24-72-101, et. seq. If a request for records is received by the City, I understand this application may be produced. The City of Loveland does not discriminate on the basis of disability, race, creed, color, gender, sexual orientation, religion, age, national origin, or ancestry in the admission, access, or appointment to, or treatment or employment in, its programs or activities.
Verification
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Verification
  1. To receive a copy of your submission, please fill out your email address below and submit.