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Skokie Advisory Board/Commission Application

2. Village of Skokie Advisory Board/Commission Application

3. 

5. Prefix*
   -- Select One --Mr.Mrs.Ms. Miss.

   Mr. Mrs. Ms. Miss.

7. First Name

8. Last Name

9. Email Address

11. Address

13. City

14. State

15. Zip Code

17. Phone Number (Home):

18. (Work):

19. (Cell):

21. Years of Skokie residency:

22. Education:

24. No. of children in school:

25. Primary:

26. High School:

27. College:

29. Employer:

30. Occupation:

32. Business Address:

34. Local reference one:

    Please provide name and number.

36. Local reference two:

    Please provide name and number.

38. Commission Interested in (1st choice)

    Please refer to Board/Commission guide to ensure that you are available to serve.

40. (2nd choice)

42. (3rd choice)

44. Interests / Affiliations

46. Applicable experience:

48. Attach resume if desired

50. Why do you wish to serve?

Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

* indicates a required field