Form Center

2. Name:
4. Address:
6. Home Phone:
7. Business Phone:
8. Cell Phone:
10. Email:
12. I would like to be considered for membership on the following city boards/committees:
    Rank your first choice by placing "1" in the drop down. If you would consider an alternative appointment, if not appointed to the 1st choice, please place a "2" and so on in the drop down of the alternative boards/committees.
14. Board of Adjustment, Code Enforcement & Appeals
    -- Select One --1234567

    5 member board - 3 year term - No residency requirement. - Suggested background: Engineer, Architect, Building Contractor, Electric Contractor, Home Inspector, Plumbing Contractor, and/or Mechanical Contractor.
16. Planning Commission
    -- Select One --1234567

    7 member and 2 alternate member board - 3 year term - Majority of membership must be City residents. Others may be residents of Pasco County.
18. Library Board
    -- Select One --1234567

    5 member board - 3 year term - No residency requirement. - Must be a patron of the Library.
20. Airport Authority
    -- Select One --1234567

    7 member board - 3 year term - May live outside of City. - Suggested background is in an aviation related business, club or activity.
22. Historic Preservation Board
    -- Select One --1234567

    5 member board - 3 year term - Must live in the City. - Preference: Interest or background in Architecture, local history, building contracting and/or community planning.
24. Parks & Recreation Advisory Board
    -- Select One --1234567

    7 member board - 3 year term - Must be a Pasco County resident.
26. Mayor's Youth Council
    -- Select One --1234567

    7 member board - 2 year term, except that of the seven members first appointed, three shall serve for a term of seven months, four shall serve for a term of one year and seven months. - The members will be Zephyrhills area residents who are actively enrolled in a public, private high school, or home schooled in grades nine through twelve.
28. Are you a resident of the city?

    1. Yes

    1. No
29. How long have you been a resident of the city?
31. Are you a resident of the county?

    1. Yes

    1. No
32. How long have you been a resident of the county?
34. Are you a registered voter?

    1. Yes

    1. No
36. Are you a property owner?

    1. Yes

    1. No
38. Why do you wish to serve on this city board/committee?
    Please let us know why you are applying.
40. What is it in your background that has prepared you for this volunteer role?
    Please include education, other boards you have served on, where you are employed, your job, interests, hobbies, etc.
42. Do you now or have you ever served on a government appointed board or committee?

    1. Yes

    1. No
44. Where and under what circumstances did you serve on a government appointed board or committee?
46. What can you contribute to this board?
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field