Boards and Commissions ApplicationCITY OF NEDERLAND
BOARDS AND COMMISSIONS
INFORMATION STATEMENT AND APPLICATION
Please check the Board or Commission for which you are applying:
Zoning Board of Appeals Civil Service Commission
Construction Board of Appeals Planning & Zoning
Fair Housing Work Group Economic Development Corporation
Parks Advisory Board Other (Please list) ______________
THE FOLLOWING INFORMATION WILL BECOME PUBLIC RECORD IF YOU ARE APPOINTED:
Name:____________________________________________________________________
Last First Middle Initial
Home Address: ____________________________________________________________
Home Telephone: __________________________ Fax: __________________________
Profession: _______________________________________________________________
Business Name: ____________________________________________________________
Business Address: __________________________________________________________
Business Telephone: ________________________ Fax: ___________________________
PERSONAL REFERENCES:
1) _______________________________________________________________________
Name and Address Telephone
2) _______________________________________________________________________
Name and Address Telephone
Voter Registration No: _______________________________________________________
Resident of Nederland for _______________ years.
If you have previously served on a City of Nederland Board or Commission, please specify
Board or Commission and approximate dates of service: ____________________________
_________________________________________________________________________
Do you have experience that qualifies you for service on a particular Board of Commission
(i.e., licenses, degrees, certificates)? Certain Boards require qualifications such as
plumbers, architects, electricians: ______________________________________________
_________________________________________________________________________
If you have been involved in any community endeavors, please explain: _______________
_________________________________________________________________________
_________________________________________________________________________
________________________________ _________________________________
Signature Date
QUALIFICATIONS FOR APPOINTMENT TO CITY OF NEDERLAND BOARDS
The City of Nederland 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 Nederland voter, preferred, at the time of appointment.
3)Have been a resident of Nederland for at least six months before the date of
appointment unless otherwise allowed by particular board or commission.
4)Have not been finally convicted of a felony.
5)Have not been determined mentally incompetent by a final judgment of 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.
Please return this form to the address below or fax to 409.723.1550:
CITY CLERK
P.O. BOX 967
NEDERLAND, TX 77627