City of Takoma Park, Maryland

Application for City Committee

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1. Before you apply, please review information on the benefits and responsibilities of serving on a City committee.

2. Individuals with disabilities are welcome to apply. If you need an accommodation, please contact Jessie Carpenter, City Clerk, at 301-891-7267 or jessiec@takomaparkmd.gov.

Preferred Pronouns

Name of committee:

Do you currently serve on this committee?

Yes

Is this your mailing address

Yes

Mailing Address (if different):

Ward (if known)

Phone Number

Please explain briefly why you want to serve on the committee, board, or commission? (50-200 words)

Please tell the Council about yourself. If applicable, include civic experience, volunteer work, or work with other organizations, groups or teams; your occupation; and your educational and/or professional background. You may attach a resume or bio if you wish (below).

If you have additional information or comments to help the Council evaluate your application, please add here.

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The City of Takoma Park is committed to building an inclusive and racially equitable community and seeks committee members who represent the diversity of our community.

Are you Hispanic or Latino?

Yes

Please check the box that describes the race with which you primarily identify.

Gender

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