First Name*

Last Name*

Many City Advisory Boards and Committees have a residency requirement that states applicants must live in the City of Manhattan. Please provide a physical address (not a P.O. Box address).

Address*

City*

State*

KS CO MO NE OK

Zip Code*

Email Address*

Telephone (Home)*

Telephone (Work)

Occupation*

Please state why you are interested in serving on this board.*

Please specify what expertise, experience, and/or capabilities you would bring to this Board.*

How much time are you willing to invest to this Board?*

What would you like to accomplish while serving on this Board?*

How will you accomplish this?*

What other boards (city, county, school, hospital, etc.) are you currently serving on?

What other boards (city, county, school, hospital, etc.) have you served on previously?