Form Center

2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Work Number
16. Email*
17. Occupation
19. Employer
20. Are you a City of Fredericksburg Resident?*

    1. Yes

    1. No
22. Employer Address
24. City
25. State
26. Zip
28. Board / Commission you wish to serve on:*
    -- Select One --Architectural Review BoardBoard of Building Code AppealsBoard of Social ServicesBoard of Zoning Appeals Cable Television Commission Economic Development Authority Fredericksburg Arts CommissionFredericksburg Clean & Green Commission Memorials Advisory Commission Planning CommissionRecreation Commission Riverfront Task ForceTowing & Recovery BoardWetlands Board Other
29. Specify if other
31. Education
33. Volunteer Experience / Community Service
35. Areas of Interest
37. Specify membership to any other governmental or community board / commission / authority / committee
39. Provide a brief narrative outlining your reasons for seeking appointment (resume or additional information may be attached)
41. Resume or Additional Information
43. I hereby request consideration for appointment to the selected Board or Commission of the City of Fredericksburg, Virginia.
45. Applicant Signature: I understand that checking the box below is the equivalent of signing my name.*

    1. I Accept
47. Applicant name*
48. Date*
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field