Board Application

2. 

3. City Clerk
   510 North Baker Street</p> Mount Dora, FL 32757</p> (352) 735-7142 Office

   510 North Baker Street

   Mount Dora, FL 32757

   (352) 735-7142 Office

5. Application to Serve as a Board or Committee Member for the City of Mount Dora
   Please complete all of the date fields listed below.

   Please complete all of the date fields listed below.

7. First Name*

8. Last Name*

10. Address1*

12. Address2

14. City*

15. State*

16. Zip*

18. Phone Number*

20. Email Address*

22. Provide a brief statement relating to your education, experience and reason for wishing to serve*

24. Resume or additional attachments (not required)

26. Boards on which you wish to serve*

28. Upon Completion
    This form will be submitted to the City Clerk's Office.

    This form will be submitted to the City Clerk's Office.

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field