2. Date of Application
   Date of Application
4. Select the Board, Commission, or Committee(s) you are applying for

   1. Airport Advisory Board
   2. America 250 Commission
   3. Board of Adjustment
   4. Board of Public Works
   5. Downtown Business District Advisory Board
   6. Emergency Communication Center Advisory Board
   7. Emergency Services Chaplain
   8. Golf Course Advisory Board
   9. Lebanon Area Veterans Memorial Board
   10. Lebanon Housing Authority
   11. Library Board
   12. Tourism and Marketing Advisory Committee
   13. Tree Board
   14. Zoning and Planning Commission
6. Personal Information
8. First Name*
9. Last Name*
11. Home Address*
13. Mailing Address (if different than home address)
15. City*
16. State*
17. Zip*
19. Home Phone Number*
21. Email Address*
23. Length of Residency in Lebanon*
25. Occupation*
27. Occupational Status and Background*
29. What skills would you contribute to the Board or Commission?*
31. Why do you wish to serve as a Board or Commission Member?*
33. Are you currently serving on other Boards, Commissions, or Committees?*

    1. Yes
    2. No
35. If yes, please state the Board or Commission
37. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. None
39. If yes, please state the Board or Commission
41. Do you or your place of employment do business with the City?

    1. Yes
    2. No
43. If yes, please describe
45. Please list organizational affiliations
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47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field