Application for Airport Commission Membership

ATTACHMENTS TO APPLICATION MUST BE LIMITED TO TWO PAGES.

FILING DEADLINE IS 5:00 P.M., THURSDAY, FEBRUARY 19, 2015

Fax or email completed documents to cmacrina@fcgov.com or FAX: to 970.221.6295 If you have questions or need additional information, contact: City Clerk’s Office (300 LaPorte Avenue) at 970.416.2525

Eligibility Requirements: A Citizen Member (on the Northern Colorado Regional Airport Commission) is defined as an individual residing within the Growth Management Area (“GMA”) of the appointing City Council or owning or leasing real property or operating a business within the Airport area of influence as defined in the Airport Master Plan; provided such member is not an employee or City Councilmember of the Cities.

1. Contact Information:

Name

Mailing Address

Zip

Residence (if different than Mailing Address)

Zip

Home Phone

Work Phone

Mobile Phone

Email Address

Current Occupation

2. Please describe the property that you own or lease, the business location, or the residence that qualifies you to apply for this Commission.

3. Are you currently serving on a City board or commission?

4. If so, which one?
An individual may not serve on more than one board or commission at a time unless: 1) the member is the only qualified applicant for the position or 2) the member resigns his or her position on the firest board or commission prior to or upon appointment to the second board or commission.

4. Why do you want to become a member of the airport commission?

5. List any abilities, skills, licenses, certifications, specialized training, or interests you have which are applicable to this commission.

6. Briefly explain what you believe are the most important issues this commission will address, and how do you believe this commission should approach them?

7. Please specify any activities which might create a conflict of interest if you should be appointed to this commission:

8. Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)?

9. If yes, please explain in detail. State the nature and approximate date of the conviction, the sentence imposed, whether the sentence has been completed, and any other information you consider to be relevant.

9. Upon application for and acceptance of appointment, board and commission members demonstrate their intention and ability to attend meetings. If appointed, frequent nonattendance may result in termination of the appointment.
By typing my name in the space provided, I submit my electronic signature and application to the City of Fort Collins and swear or affirm under penalty of perjury pursuant to the laws of the State of Colorado: (1) that I meet the eligibility requirements of the position sought and (2) that the information provided in this application is true and correct to the best of my knowledge.

Signature
Date Submitted

10. Optional: How did you learn of this commission?

Newspaper
Cable
Website
Social Media
Other Please enter an 'other' value for this selection.

11. Please attach your 2-page resume.

File: {{filename}} delete