2. NAME*
3. DATE*
5. STREET ADDRESS*
7. CITY*
8. STATE*
9. ZIP
11. EMAIL ADDRESS*
12. PHONE NUMBER*
14. EMPLOYMENT*
15. OCCUPATION*
17. EDUCATION*
18. RESIDENT*

    1. YES
    2. NO
19. IF YES, HOW LONG?
21. ANY PREVIOUS RELATED EXPERIENCE*
23. REFERENCES
25. Please select the Authorities/Boards/Commissions of interest and return to the Borough Manager's Office, 601 Thorn Street, Sewickley, PA 15143, Phone #412-741-4015, Fax #412-741-2421.
27. Authorities/Boards/Commissions*

    1. Historic Review Commission
    2. Planning Commission
    3. Shade Tree Commission
    4. Zoning Hearing Board
    5. Civil Service Commission
29. *The Historic Review Commission meets the 1st Monday of each Month at 7:00 pm; Planning Commission meets the 1st Wednesday of each Month at 7:00 pm; Shade Tree Commission meets the 1st Monday of each month at 7:00 pm; Zoning Hearing Board meets the 1st Tuesday of each Month at 7:00 pm; Civil Service Commission meets as needed.
33. IN YOUR OPINION, WHAT IS THE ROLE OF THE AUTHORITY/BOARD/COMISSION FOR WHICH YOU ARE APPLYING*
35. WHY DO YOU WANT TO SERVE ON THE AUTHORITY/BOARD/COMMISSION FOR WHICH YOU ARE APPLYING?*
37. COMMENTS:
39. NOTE: As an applicant for appointment, this information will be made available to the press and public.
43. Applications will remain on file for one (1) year from date of filing.
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45. 1. Receive an email copy of this form.
46. Email address

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47. Submit

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