2. 
4. Thank you for your interest in serving as a volunteer for the City of Wheat Ridge! Please complete this application in order to be considered as a candidate. Each application will be thoroughly reviewed by Wheat Ridge City Council. Applications will be kept on file for one year for any future vacancies. Application deadlines may vary.
6. Select one Board, Commission or Committee

   1. Board of Adjustment
   2. Building Code Advisory Board
   3. Cultural Commission
   4. Election Commission
   5. Housing Authority
   6. Liquor Licensing Authority Board
   7. Parks and Recreation Commission
   8. Planning Commission
   9. Renewal Wheat Ridge
   10. Active Adult Ctr. Advisory Committee
7. Type or Term of Application*

   1. New Applicant
   2. Reappointment
8. In which district do you reside?

   1. District I
   2. District II
   3. District III
   4. District IV
10. District Map -https://www.ci.wheatridge.co.us/1175/Council-District-Maps
    To find your district click here
12. First Name*
13. Last Name*
15. Address1*
17. Address2
19. City*
20. State*
21. Zip*
23. Phone Number*
24. Alternate Phone Number
26. Email Address*
28. Current Occupation
29. Employer
31. Are you a Wheat Ridge resident?*

    1. Yes
    2. No
32. If yes, how long have you been a resident?
33. Are you a registered voter?*

    1. Yes
    2. No
35. Have you served on a Board, Commission, or Committee before?*

    1. Yes
    2. No
36. If yes, which one?
38. Tell us about yourself and why you would like to be a member of this board, committee or commission. *
40. Briefly explain what you believe are some of the important issues facing this board, committee or commission, and how do you think you can have an impact on these issues?*
42. Please list any community involvement, special work experience or skills that would enhance your ability to serve on this board, committee or commission:*
44. Please specify any activities which might create a conflict of interest that would prevent you from taking official action should you be appointed to this board, committee or commission:*
46. If appointed, you agree to attend regular meetings (typically monthly), review materials prior to meetings, and help with occasional projects. Time commitment can vary. Are you able to fulfill this commitment?*

    1. Yes
    2. No
47. Are there certain times when you wouldn't be available due to job or other commitments?
49. Notices, agendas, and communications are sent electronically or posted online. Please describe your level of comfort using technology.
50. Upload any additional supporting documents (e.g. resume, cover Letter)
52. All boards and commissions members are appointed by the Wheat Ridge City Council and serve without compensation. Boards and commissions are established for the purpose of acquiring and reviewing information to make recommendations to City Council. Information submitted in this application is considered public record and subject to the Colorado Open Records Act (CORA)
54. By checking the boxes below, I hereby certify and acknowledge, understand, and agree to the following:
56. The information provided in this application is true and correct to the best of my knowledge. *

    1. Yes
58. I have read and understand the qualifications for the board, committee or commission to which I have applied, and certify I meet the qualifications.*

    1. Yes
60. I understand that if required, I am able and willing to attend meetings, including quasi-judicial hearings, held in person or virtually by established phone or video conferencing methods such as (Zoom, GoToMeeting, Microsoft TEAMS, etc.)*

    1. Yes
62. I understand that board and commission members demonstrate their intention and ability to attend meetings. If appointed, frequent nonattendance may result in termination of the appointment.*

    1. Yes
64. I understand some positions may require a criminal background check to be conducted. If that applies for this position, I therefore authorize the City of Wheat Ridge to conduct a criminal background investigation. *

    1. Yes
66. For further information or inquires please contact:
68. Stephanie Pomponio at 303-235-2977, WRBNC@ci.wheatridge.co.us
69. Clerk's office at 303-235-2816, cityclerk@ci.wheatridge.co.us
71. Applications that are not submitted online may be submitted via email to WRBNC@ci.wheatridge.co.us. This application may be printed, completed, and dropped off or mailed to Wheat Ridge City Hall, 7500 W. 29th Ave. Wheat Ridge, CO 80033 Attn: Stephanie Pomponio
Leave This Blank:


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

    This field is not part of the form submission.

75. Submit Submit and Print

* indicates a required field