2. Select the Board, Commission, or Committee applying for*
   -- Select One --Select OneBrownfield Redevelopment AuthorityBuilding AuthorityBuilding Code Board of AppealsCable Communications CommissionCity Beautiful CommissionCivic CommissionCultural CommissionDowntown Development AuthorityEnvironmental Advisory BoardHistorical CommissionRecreation CommissionPlanning CommissionTraffic Safety CommissionZoning Board of Appeals & Adjustments
4. Personal Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Home Phone Number
18. Cell Phone Number (if different)
20. Business Phone Number
21. Fax Number
23. Email Address
25. Qualifications*
    (May include schooling, occupation, special interests, etc. You may include other information that you feel is important, such as a resume.)
27. Are you a registered voter*

    1. Yes
    2. No
29. Organization Membership Information
31. Are you currently serving on other Boards, Commissions, or Committees?*

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

    1. Yes
    2. No
37. If yes, which
39. As of this date, I am not in default to the City of Trenton for any purpose, I have been a resident for at least two years, am a qualified and registered elector of the City and a citizen of the United States
41. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
43. Electronic Signature
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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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