Boards and Commissions Application

Application can be made by:

  1.  Complete webform below and click submit application; or
  2.  Download PDF Application form, complete and submit to kgibeau@grandrapidsmn.gov or mail to:
                              City of Grand Rapids
                              420 N. Pokegama Avenue
                              Grand Rapids, MN 55744

Supporting Documents

PDF icon board_commission_application.pdf (131 KB)
CONTACT INFORMATION
Please provide your first, middle and last name.
Please provide us with the best number to contact you.
BOARDS AND COMMISSIONS
Please select all Boards & Commissions on which you would like to serve.
Boards & Commissions *
BACKGROUND INFORMATION
Do you have special qualifications that you feel would make you effective on a Board or Commission? (i.e. work experience, volunteering, education, hobbies, etc?)
Please add any other comments or information you would like us to know. Example: How did you become interested in serving on Boards & Commissions?
City Relationships: *
Are you related to any City employee or elected official?
If you answered yes to the previous question, please provide the names of City employees and/or election officials you are related to.
Residency:
Some Boards & Commissions have residency requirements. Please let us know if you reside inside the City limits.
DATA AUTHORIZATION:
If appointed, I authorize the City of Grand Rapids to release the following private data to the general public, City staff, Mayor and City Council members upon data request submitted to the City. The person receiving such private data must use it only for lawful purposes. Select all that apply.
BACKGROUND CHECK AUTHORIZATION:
The City of Grand Rapids requires all applicants wishing to serve on a City Board, Commission or Authority to complete a background check.
Please provide former names used, including maiden and alias'.
Please provide all addresses where you resided in the last 10 years.
Date of Birth.
Please fill in your Driver's License Number including state of issuance.
AGREE: *
Select all that apply:
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