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2. Requirements
   You must be a resident of the City of Lodi in order to volunteer to represent the City of Lodi on the following Boards and/or Commissions.
4. First Name*
5. Last Name*
7. Street Address*
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address
16. Occupation*
18. I am interested in serving on the following Boards and/or Commissions:*

    Please limit to 3.

    1. Board of Appeals
    2. Board of Review
    3. Ethics Inquiry Board
    4. Library Board
    5. Lodi Area EMS Board

    1. Lodi Area Fire Board
    2. Parks Commission
    3. Plan Commission
    4. Police Commission
    5. Utilities Commission
19. Have you served on a public Board or Commission before?*

    1. Yes
    2. No
21. Board or Commission Experience
23. Relevant Experience and Qualifications*
25. Civic Involvement
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field