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2. Select the Board, Commission, or Committee applying for*
   -- Select One --Rawlins Shooting Ranges Advisory BoardDowntown Development AuthorityUrban Systems CommitteeOld Pen Joint Powers BoardParks & Rec Advisory Committee - Youth PositionsParks & Rec Advisory Committee - Adult PositionsRochelle Ranch Golf Advisory Board
4. Contact Information
6. First Name*
7. Last Name*
9. How do you pronounce your name? This will help council say in correctly during a motion to appoint.
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Email Address
21. Contact Phone Number*
23. Residency Information
25. How long have you lived in Rawlins?*
27. Are you a registered voter? *

    1. Yes
    2. No

    Note - this is required for Joint Powers Boards in the State of Wyoming. Please see WY Stat § 16-1-106(a) and § 22-1-102(xxvi). 

29. Education, Experience and Hobbies
31. What knowledge, skills and experience will you bring to the Board/Commission/Committee you are applying for?
33. Occupation, Profession or Position*
35. Please tell us about your work experience. *
37. Please tell us about your education.
39. Please tell us about your interests. *
41. Organization Membership Information
43. Please list any current or past experience on City Boards, Commissions, or other City volunteer opportunities, as well as any offices held:
45. Please list current activities or volunteer work (i.e., involvement in the areas of Health, Social Services, Education, Recreation, Youth, Aging, Government, Community Relations, Art, History, Agricultures, etc.):*
47. Do you have a unique perspective regarding issues facing the board(s)?*
49. Please list, if applicable, any curcumstances that may restrict your availablity to serve. Please also feel free to use this space to provide us any additional information. Thank you!
51. Please feel free to provide us with any additional information you believe would assist us in our appointment process. Use additional sheets if necessary. Letters of recommendation are welcome but certainly not a requirement.
53. Upload any additional documents, such as letters or resumes
55. When this form is submitted, you will be directed to a page that says "Your Form Has Been Submitted Successfully. Thank you for your submission. We will respond to your inquiry as soon as we can, if necessary." If you do not see this page, or wish to verify receipt of your submission, please call 307-328-4500 ext. 1022 or email crelations@rawlinswy.gov
57. I certify that all information contained on this application is true and complete to the best of my knowledge and belief. I understand that any misrepresentations or falsifications may result in removal of appointment.
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59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field