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2. One way for Keene residents to actively participate in local government is to become an member of a board or commission. If you would like to get involved in your local government, please complete this application.
   
   Applications will only be kept for 2 years. After that time, a new application must be completed and submitted for consideration. Please note that all information on this application is public information pursuant to the provisions of the Texas Open Records Act.
4. Name
5. Date
   Date
7. Address
9. Home Phone
10. Cell Phone
11. Work Phone
13. Email Address
15. Employer
16. Occupation
18. How many years have you been a Keene resident?
19. Are you a registered voter?

    1. Yes
    2. No
21. Are you currently serving on a City Board or Commission?

    1. Yes
    2. No
22. Have you previously served on a City Board or Commission?

    1. Yes
    2. No
24. If yes, please list the board or commission and the dates of service.
26. Are you or any member of your family related to a City of Keene employee(s)?

    1. Yes
    2. No
27. If yes, please list the names of the person(s) and indicated the relation.
29. Board Preferences
    Please indicate the Board or Commission you are interested in serving on. If you have more than one Board or Commission you are interested in, please list them in order of preference.
31. Preference 1
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
32. Preference 2
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
33. Preference 3
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
35. Preference 4
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
36. Preference 5
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
37. Preference 6
    -- Select One --Board of AdjustmentBuilding Standards CommissionKeene Business Development CorporationKeene Economic Development CorporationParks and Recreation BoardPlanning and Zoning Commission
39. Please list any additional information you feel would be beneficial to serving on a Board or Commission.
41. Please note that all Board or Commission members are appointed by City Keene Council and must be willing to attend and participate in all scheduled meetings. The city charter and ordinances authorize the existence of each board or commission and establish them as legal arms of city government. If you have any questions, please feel free to contact the City Secretary.
43. Applicant Signature
44. Date
    Date
46. Received By
47. Date
    Date
49. Board or Commission Appointed To
50. Date
    Date
52. Term of Service
    Term of Service Start Date

    —

    Term of Service End Date
53. Renewal Date
    Renewal Date
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field