City of Fairmont

info@fairmontwv.gov

200 Jackson Street, Fairmont, WV, 26554, US

304-366-6211

City of Fairmont Board and Commission Application

By completing this form, you are indicating your interest to serve on a city board, commission, or committee. The Fairmont City Council and/or the City Manager make the appointments. All appointments remain at the discretion of the City Council and/or the City Manager. This application is a public document and will be on file for two (2) years.

Phone Number

Occupation:

Employer:

Do you reside within the city limits of Fairmont?

Yes

If yes, how long?

Education:

Elementary

High School Diploma (or equivalent)

Bachelor's Degree (or equivalent)

Graduate Degree

Degree/Major:

Certifications or Vocational Training:

Other relevant skills:

Volunteer experience and community involvement (please give dates):

If appointed, could you meet:

Morning

Afternoon

Evening

How did you hear about this board or commission? (Ex. Word of mouth, social media, from a current board or commission member, etc.)

Have you served on any boards, commissions, or committees in the past? If so, please list:

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First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.