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2. Instructions
   All requested information must be furnished on the application itself. Resumes, attachments and other supporting documentation may be included but cannot be substituted for an application form. It is important that you answer all questions on your application fully and accurately.
4. Applications received after the deadline will not be considered.
6. Commission Being Applied for:

   1. Aging and Senior Citizens Commission
   2. Parks and Recreation Commission
   3. Planning Commission
   4. Public Safety Commission
8. Last Name
9. First Name
10. Middle Name
12. Address
14. City
15. State
16. Zip Code
18. Home Phone
19. Business Phone
21. Email
23. Have you ever been convicted of a crime?

    1. Yes
    2. No
24. If yes, please explain:
26. Are you a registered voter within the City of Cudahy?

    1. Yes
    2. No
28. How long have you lived within the incorporated city limits of the City of Cudahy?
30. Have you ever been a member of any Commission, or employed by the City of Cudahy?

    1. Yes
    2. No
32. If "Yes," in what capacity?
34. Occupation and Place of Employment:
36. List community organizations or professional groups in which you hold active membership(s):
38. List positions of responsibility held in any of the above organizations:
40. Please state your reasons as to why your background and/or experience makes you a suitable candidate for appointment to his position:
42. Please state the reasons you are interested in filling this vacancy:
44. Please briefly express your views regarding current and future development in Cudahy:
46. References
48. 1. Name
49. Phone
51. 2. Name
52. Phone
54. 3. Name
55. Phone
57. Letters of Recommendation may be attached to application, but cannot be substituted in lieu of the requested references name and contact information.
59. Letter of Reference
60. Letter of Reference
61. Letter of Reference
63. In compliance with state law, City Council members are required to file a Statement of Economic Interests upon appointment to office, and annually thereafter. Applicants are advised that if appointed they will be required to make information available as to any potential conflict of interest arising from their business or affiliations where that affiliation or business may be doing business with the City of Cudahy, or the decisions taken by the City of Cudahy may influence that business or affiliation.
65. I, the undersigned, certify that the above information is true and correct and that I am sincerely interested in serving in this position for the City of Cudahy and, if appointed, will be available for evening meetings as may be required.
67. Applicant eSignature
68. Date
    Date
Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit

* indicates a required field