Action Center / Board and Commission Application / Davenport, Iowa

Skip over navigation

Action Center Home | Log In

Board and Commission Application

Step 1 of 1

Click here to download the Financial Disclosure Form if necessary

* Denotes a required field

Name*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Email*

Please Do Not Complete The Following Field

Primary Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Secondary Phone

Phone Area Code-Phone 3-Phone 4

Gender*

Male

Female

Not Specified

Race / Ethnicity*

Financial Disclosure

Do you or a member of your immediate family have more than 5% ownership interest in an organization?

Do you or a member of your immediate family serve in an executive/management position with financial decision-making authority in an organization which does or could provide goods or services to the City of Davenport?

Do you have any financial disclosures?*

Yes No

If yes, please list The name(s) of the business, type of interest, and self or family member

Company (Employer)*

Occupation*

Bio*

Experience, Education which qualifies you for this board/commission*

What contributions can you make, or state the reason for applying*

Are you a robot?*

Affirmative Action Advisory Commission	Housing Commission
Citizen Advisory Committee	Riverfront Improvement Commission
Civil Rights Commission	Library Board of Trustees
Civil Service Commission	Parks & Recreation Advisory Board
Combined Construction Code Board of Appeals and Review	Plan & Zoning Commission
Design Review Board	Zoning Board of Adjustment
Historic Preservation Commission

Board and Commission Application

Board and Commission Application

Dialog Title