Advisory Boards and Commissions Volunteer Application
Thank you for your interest in serving the City of Port Orange. Your completion of this application is necessary so that the members of the City Council can thoroughly review each application as part of their consideration for your appointment.

You may also download a printable PDF version of this application, and mail or deliver it if you wish.

Boards and Commissions
Please choose the Board(s)/Commission(s) for which you wish to apply. If applying for more than one Board/Commission, indicate the order of preference in the space below the list.

Check the boards you wish to apply for:

Planning Commission*
Audit & Budget Advisory Board
Youth Advisory Board
Pension Boards*
General Employees
Police
Fire
Order of Preference
ALL OF THE ABOVE BOARDS/COMMISSIONS ARE SUBJECT TO THE “SUNSHINE LAW”
* MEMBERS OF THESE BOARDS/COMMISSIONS ARE REQUIRED TO FILE FINANCIAL DISCLOSURES WITHIN 30 DAYS OF DATE OF APPOINTMENT.

 

Personal Information

First Name

Last Name

Date of Birth

Telephone

E-Mail Address

Business Telephone

Are you a registered voter in Port Orange?
Yes No

Address

City Council District

How long have you been a resident of Port Orange?

Are you currently serving on a City Board?
Yes No

If yes, when and which board?

 

References

Please list three references (business and/or personal)

Reference 1: Name, Address and Telephone Number

Reference 2: Name, Address and Telephone Number

Reference 3: Name, Address and Telephone Number

 

Education

High School

Date Graduated High School

College

Date Graduated College

Degree

 

Work Experience

 

Interests/Activities

 

Community Involvement

 

Why do you desire to serve on these boards?

 

Resume/Additional Information
A resume or additional information may be included below.

 

I understand the responsibilities associated with being a board member, and I have adequate time to serve if appointed

Type your name to sign

Date: 07/06/2015

Note: If you have questions concerning the duties and responsibilities of any of the above Boards/Commissions, please contact the City Clerk's Office at 386-506-5563.


 

 

 

Important Numbers
Main Number
386-506-5500

Customer Service (Water)
386-506-5720

Community Development
& Building Permits

386-506-5600

Code Compliance Hotline
386-506-5604

Public Works
386-506-5575

Non-Emergency and After Hours City Operations, Police & Animal Control
386-756-7400

Fire Non-Emergency
386-506-5900

Parks and Recreation
386-506-5850

Public Utilities Emergency
386-756-5380

City Manager, Mayor
& City Council

386-506-5501

Click here to go to the Stormwater Management page
668.6076. Public records status of e-mail addresses; agency website notice: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.