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2. Please check all the boards or commissions for which you are applying:

   1. Board of Adjustment
   2. Citizens Advisory Committee
   3. Civil Service Commission
   4. Convention and Visitors Bureau Board
   5. Economic Development Corporation

   1. Historic Preservation Board
   2. Housing Authority Board
   3. Library Advisory Board
   4. Planning and Zoning Commission
   5. Other
4. If other, please list:
6. the following information will become public record if you are appointed:
8. Name
9. Date of Birth
11. Home Address
12. Email Address
14. City
15. State
16. Zip Code
18. Phone Number
19. Fax Number
21. Profession
22. Business Name
24. Business Address
26. City
27. State
28. Zip Code
30. Business Phone
31. Business Fax
35. Personal References
37. Name
38. Phone Number
40. Address
42. City
43. State
44. Zip Code
46. Name
47. Phone Number
49. Address
51. City
52. State
53. Zip Code
57. How long have you been a resident of the City of Orange?
59. If you have previously served on a City of Orange Board or Commission, please specify Board or Commission and approximate dates of service:
61. Do you have experience that qualifies you for service on a particular Board or Commission (i.e., licenses, degrees, certificates)? Certain Boards require qualifications such as plumbers, architects, electricians:
63. If you have been involved in any community endeavors, please explain:
65. 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. I agree.
67. Electronic Signature
68. Date
    Date
70. Qualifications for Appointment to City of Orange Boards

    The City of Orange Policy establishes certain qualifications which must be met by all members of City Boards and Commissions. In addition to any special qualifications for service on a particular board, a board member must:

    1. Not be delinquent on any City taxes or utilities.
    2. Be a qualified City of Orange voter at the time of appointment.
    3. Have been a resident of Orange for at least six months before the date of appointment.
    4. Have not been finally convicted of a felony.
    5. Have not been determined mentally incompetent by a final judgment of the court.

    Thank you for taking the time to complete this application.  It will be helpful to the City Council in making appointments. This application must be fully completed for consideration by the City Council. You may also attach a resume if you so desire.

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72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

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