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2. Name
3. Date
   Date
5. Address
6. Phone
7. Email
9. Employer
10. Employer Phone
12. How long have you lived in the City of Portland?
14. Please mark your choice(s).

    1. Board of Review
    2. Building Board of Appeals
    3. Downtown Development Authority
    4. Light and Power Board

    1. District Library Board
    2. Parks and Recreation Board
    3. Planning Commission

    1. Portland Area Municipal Authority
    2. Tree Management Commission
    3. Zoning Board of Appeals
16. If more than one please list them in order.
18. Please tell us your qualifications.
20. Are you a high school graduate?*

    1. Yes
    2. No
21. Are you a college graduate?

    1. Yes
    2. No
23. List name of the college or university you attended and the level of degree earned.
25. List your professional and work experience.
27. List your community activites, interests and service.
29. References (optional)
    Please provide name, address and telephone number.
31. File Attachment
    You may also attach other information, such as a resume, if you wish.
Leave This Blank:


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

    This field is not part of the form submission.

35. Submit

* indicates a required field