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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