City of Batavia Form Center

2. Application for appointment to: *

   Example: City Council vacancy 

4. First Name*
5. Last Name*
7. Home address*
9. Cell Phone
10. Home Phone

    (If applicable)

12. Email*
13. How long have you been a resident of Batavia?
15. Occupation/Profession
16. Years of service in profession
18. Education
20. Community participation and service (past and present)
22. Special qualifications for community service
24. Why do you desire this appointment?*
26. If Council, Board or Commission you are applying for is filled by someone else, would you consider serving in another capacity?

    1. Yes
    2. No
28. If your answer above is "yes," please list any other board or commission on which you are willing to serve
30. If desired, you may submit a letter of application and/or resume with this form.
32. Public application

    Please note that by submitting a completed application for consideration of service on a City of Batavia City Council, Board or Commission, your information becomes an official public document and may be shared with City Council and the general public. 

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field