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Application for Appointment to Pedestrian Advisory Committee

Complete this online application to be considered for appointment. Applications will be review by board staff. The City Council and Mayor approve all appointees.

Information provided on fields with this icon is public according to the Minnesota Data Practices Act.
You are applying for
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Membership Requirements
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Information provided here is open to the public per The Minnesota Data Practices Act Applicant Details
Information provided here is open to the public as per The Minnesota Data Practices Act

Please Enter First Name.


Please Enter Last Name.


Please Enter Address.

Please Enter City.


Please Select State.

Please Enter only digits.

Please Enter Minimum 5 characters.

Please Enter no more then 10 characters.

Please Enter Postal Code.


Please Select Ward.

Please Enter Home Phone.

Please Enter Valid Phone Number.


Please Enter Valid Email Address.

Please Enter Email Address.

Employer Information


Please Enter only digits.

Please Enter Minimum 5 characters.

Please Enter no more then 10 characters.


Please Enter Valid Phone Number.

Please Enter Valid Fax Number.


NOTE: If appointed, Minnesota statute 13.601 requires that a telephone number and/or an email address where the appointee can be reached and residential address will be considered public data.

Please Select Public Contact Preference.


Please Enter This Field.




References: List names,addresses and telephone numbers of no more than 3 references

References

Please Enter Name.

Please Enter Valid Phone Number.





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