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2. Residency Information

   Residency Requirements

   Must be an Elk River resident for the following

   • Economic Development Authority (EDA)
   • Heritage Preservation Commission
   • Housing and Redevelopment Authority (HRA)
   • Planning Commission
   • Utilities Commission

   Must be a Sherburne County resident for the following:

   • Library Board

   Residency does not matter for the following:

   • EDA Beautification Committee
   • EDA Together Elk River Committee
   • Energy City Commission
   • Joint Finance Committee
   • Multipurpose Facility Advisory Commission
   • Parks and Recreation Commission
4. Select the Commission applying for*
   -- Select One --Select OneEconomic Development AuthorityEnergy City CommissionHeritage Preservation CommissionHousing & Redevelopment AuthorityLibrary BoardMultipurpose Facility Advisory CommissionParks and Recreation CommissionPlanning CommissionUtilities CommissionEDA Beautification CommitteeJoint Finance CommitteeEDA Together Elk River Committee
6. First Name*
7. Last Name*
9. Address1*
11. City*
12. State*
13. Zip*
15. Home Phone Number
16. Cell Phone Number
18. Email Address
20. Public Contact Information*

    The city maintains a directory of current board/commission members on the city's website. Once appointed members are required to provide a telephone number, email address, or both where the appointee can be reached. This is the contact information we will include in our online directory. Please indicate which contact information you would like us to use:

    1. Home Phone Number
    2. Cell Phone Number
    3. Email Address
22. Employer*
23. Occupation*
25. Why are you interested in serving on a city commission?*
27. What skills, training, and experience would you bring to the commission for which you seek appointment?*
29. Conflict of Interest*

    Conflict of Interest is defined as the participation in any activity, recommended action, or decision from which the individual has or could have the potential to receive personal gain, whether it be direct or indirect. Do you have any legal or equitable interest in any business, however organized, which could be construed as a conflict of interest?

    1. Yes
    2. No
31. If yes, explain:
33. How did you hear about this vacancy?
    -- Select One --FacebookCity WebsiteStar NewsTwitterWord of MouthOther
35. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. Agree
37. Electronic Signature*
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field