Citizen Advisory Group Application

Citizen Advisory Group application for: *

Economic Development Committee

Historic Review Board

Transportation Advisory Board

Economic Development Committee Applicants ONLY: Please indicate the business area you wish to represent:

At Large

Bolton

Note: Cascade Summit, Chamber, Home Based, Robinwood, and Willamette positions are already filled.

Contact Info

Name: *

Address: *

City: *

Email Address: *

Primary phone: *

Secondary phone:

State: *

Zip Code: *

Years of Residence in West Linn: *

Occupation: *

Professional Activities: *

Community Affiliations and Activities: please describe your current and previous community affiliations and activities: *

Questions About Citizen Advisory Group Service

Please explain why you would like to serve on this Citizen Advisory Group, and give any other background you might have in this area: *

What should be the top goal or purpose of this Citizen Advisory Group, and how would your membership on this group contribute to attaining that goal or purpose: *

Submission Acknowledgement: *

By submitting this form, I certify that all statements on this application are true and complete to the best of my knowledge. I understand false or incomplete statements shall be sufficient cause for disqualification or dismissal.

Today's date: *