Application Form

Name
Home Address
City, State	,
Zip Code
Home Phone
Work Phone
Email
Occupation
Place of Employment
High School Graduate?	Yes No
College Graduate?	Yes No
College Name(s)
College Degree(s)
Have you served on a City Board or Commission?	Yes No If yes, which ones?
Statement	Please briefly describe why you want to participate in the City Management Academy, and list past community/neighborhood activities:
Participation	Are you available one to two nights per week (6:30-9pm) and on Saturdays (9am-noon) to attend the learning sessions for this program? Yes No Would you be willing to participate in a voluntary program where you observe key City staff members carrying out their duties? Yes No