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Board Application Form

  1. Public service opportunities are offered by the City of Anna without regard to race, color, national origin, religion, sex or disability. To be eligible for appointment to a Board or Commission, a candidate must be a qualified voter in Anna.

  2. It is recommended that you read the Anna City Code of Ethics before completing this application. You can find the Code of Ethics on the Boards and Commission webpage.

  3. Personal Information

  4. MM/DD/YYYY

  5. Sex:

  6. Residency Information

  7. Are you a registered voter*

  8. Education and Hobbies

  9. Organization Membership Information

  10. Are you currently serving on other Boards, Commissions, or Committees?*

  11. Have you served on a Board, Commission, or Committee before?*

  12. Do you have any relatives or members of your household serving as an elected or appointed official of the City of Anna?*

  13. Are any relatives of your household employed by the City of Anna?*

  14. I acknowledge that I have read the Anna City Code of Ethics*

  15. Do you understand and agree to adhere to the Code of Ethics?*

  16. Have you ever been convicted of a felony or a crime of moral turpitude? (Note: Generally, a crime of moral turpitude is a crime involving dishonesty)*

  17. Do you understand the term length for the position you have applied for and the attendance policy?*

  18. Do you understand the importance of attendance at all regular meetings of the board or commission you have applied for and the importance of completion of the term? *

    Any member of a board, commission, or committee who is absent from three (3) consecutive regular meetings, or twentyfive (25%) of regularly scheduled meetings during the twelve-month (12-month period immediately preceding and including the absence in question, without explanation acceptable to a majority of the other members shall forfeit his or her position on the boards, commission or committee. - City of Anna Home Rule Charter, Article 8.01 (e)

  19. Do you have any physical or mental constraints which may limit your ability to perform the duties of a board member or commissioner?

  20. Pursuant to the Americans with Disabilities Act, the City of Anna will make reasonable efforts to accommodate persons with qualified disabilities during the Boards and Commissions interview process. If you require special accommodations, please contact the Office of the City Secretary at 972-924-3325 at least five days in advance of any scheduled interview.

  21. Have you completed the City of Anna’s Citizen Academy?*

  22. If appointed, will you complete the mandatory online training within 90 days of your appointment and any other necessary training sessions?*

  23. Disclaimer and Electronic Signature

    I certify that all statements that I have made on this application and other supplementary materials are true and correct. I hereby authorize the City of Anna to investigate the accuracy of this information from any person or organization, I release the City of Anna and all persons and organizations from all claims and liabilities arising from such investigation or the supplying of information for such investigation. I acknowledge that any false statement or misrepresentation on this application or supplementary materials will be cause for refusal of appointment or immediate dismissal at any time during the period of my appointment.

  24. Acknowledgement*

  25. Leave This Blank:

  26. This field is not part of the form submission.