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2. Name*
3. Email Address*
5. Address*
7. City*
8. State
9. Zip Code*
11. Home Phone Number*
12. Mobile Phone Number*
13. NR Residency (in years)*
15. Educational Background

    Maximum 300 characters allowed

17. Board or Commission of Interest*
    -- Select One --Joint Plan Commission & ZBACitizen Recreation CommitteeCivil Service CommissionRecycling CommissionEconomic Development CommissionPolice Pension BoardFirefighters' Pension Board100 Year Celebration Committee
19. Volunteer Experience

    Maximum 300 characters allowed

21. Community Involvement

    Maximum 300 characters allowed

23. 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.
25. Electronic Signature
26. Date
    Date
28. Disclosures
    • Resumes may be submitted in lieu of this form
    • All applications or resumes will be kept on file in the Village Clerk's Office
    • Appointments to certain Boards & Commissions require the filing of a Statement of Economic Interest with the Cook County Clerk's Office
    • Appointments to Village Boards & Commissions require the one-time completion of the Open Meetings Act training (IL Public Act 97-0504)
30. * Indicates a required field
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field