NAME *

First

Last

Address *

Address Line 1

City

State

Zip Code

Mailing Address(if different)

Contact Number *

EMAIL *

Are you a qualified voter in the City of Mount Pleasant? *

Yes
No

Do you live within the city limits? *

Yes
No

come you

If yes, how long?

Employer name, address, and occupation *

To the best of your knowledge, are you employed by, or a member of, any entity (business or non-profit) with proposals, programs, requests, businesses, applications, licenses, or any other matters which may come before a board or commission for review, funding, support, or approval during the next two years? *

Yes
No

If yes, list entity and interest:

Volunteer Experience/ Community Service *

What do you hope to accomplish by serving? *

Board(s), Commission(s), or Committee Interest *

What experiences qualify you to serve on the Zoning Board of Adjustment?

Leave blank if you're not applying for Planning and Zoning

Signature of Applicant *

Date *

THANK YOU FOR YOUR INTEREST IN THE CITY OF MOUNT PLEASANT APPLICATIONS ARE KEPT ON FILE FOR TWO YEARS FROM DATE OF SUBMISSION

CONTACT MPTX

VISIT MAIN STREET

UPCOMING CALENDAR

MAIN STREET ADVISORY COMM.

CITY COUNCIL MEETING