Form Center

2. Applicant Information
4. Full Name of Applicant *
5. Home Address *
6. City & State *
8. Zip Code*
9. Primary Phone Number*
10. Secondary Phone Number
12. Email *
13. Secondary Email
15. Do you reside in Baytown?*
16. If yes, how long? (Years & Months)
20. Occupational Information

    1. Employed
    2. Not Currently Working
21. If employed, please list the following:
22. Employer Name
24. Position/ Title
25. Employer Address
26. City, State & Zip
30. Preference
    In order of preference, list the Board, Commission, Committee, or Task Force on which you wish to serve:
32. 1st Preference *
    -- Select One --Baytown Area Water Authority Baytown Crime Control and Prevention DistrictBaytown Fire Control, Prevention, and EMS District Baytown Hospitality Public Facilities COrporations Baytown Municipal Development Baytown Redevelopment Authority TIRZ No. One, City of Baytown Board of Adjustment Civil Service CommissionConstruction Board of Adjustments and Appeals Industrial Appraisal Review Board Planning and Zoning CommissionSign CommitteeAnimal Control Advisory Committee Baytown Police Advisory Committee Charter Review Committee Community Development Advisory CommitteeEthics CommissionLibrary Board Parks and Recreation Board Baytown Housing Authority
33. 2nd Preference
    -- Select One --Baytown Area Water Authority Baytown Crime Control and Prevention District Baytown Fire Control, Prevention, and EMS District Baytown Hospitality Public Facilities CorporationsBaytown Municipal Development District Baytown Redevelopment Authority TIRZBoard of Adjustment Civil Service Commission Construction Board of Adjustment and Appeals Industrial Appraisal Review Board Planning and Zoning Commission Sign CommitteeAnimal Control Advisory CommitteeBaytown Police Advisory Committee Charter Review Committee Community Development Advisory CommitteeEthics CommissionLibrary Board Parks and Recreation Board Baytown Housing Authority
34. 3rd Preference
    -- Select One --Baytown Area Water Authority Baytown Crime Control and Prevention DistrictBaytown Fire Control, Prevention, and EMS DistrictBaytown Hospitality Public Facilities CorporationsBaytown Municipal Development District Baytown Redevelopment AuthorityTIRZ No. One, City of BaytownBoard of AdjustmentCivil Service CommissionConstruction Board of Adjustments and AppealsIndustrial Appraisal Review Board Planning and Zoning Commission Sign CommitteeAnimal Control Advisory CommitteeBaytown Police Advisory CommitteeCharter Review CommitteeCommunity Development Advisory CommitteeEthics CommissionLibrary Board Parks and Recreation BoardBaytown Housing Authority
36. Do you want to withhold your home address, home telephone, personal cell phone numbers and personal email as provided?*
    -- Select One --Yes No
40. Applicant Questionnaire
42. What professional license(s), certification(s), or training do you have that may qualify you for service?
44. What special experience/knowledge do you have that may qualify you for service?
46. Please explain why you wish to volunteer to serve on a Board, Commission, Committee, or Task Force?*
48. Please provide any additional information you feel would be useful to the City Council in considering your application.
50. Please include additional information as needed. A cover letter and/or resume may also be submitted with this application.
52. Name of Applicant *
    I certify that the foregoing information is true and complete to the best of my knowledge and belief.
53. Signature *
54. Date *
56. Thank you for your interest in serving on a City of Baytown Board, Commission, Committee, or Task Force!

    Completed applications may be submitted via mail to: City of Baytown, City Clerk, P.O. Box 424, Baytown, Texas 77522-0424, via email to: cityclerk@baytown.org, via fax to: (281) 420-5891, or in person to the City Clerk’s Office, City of Baytown City Hall. Should you have any questions regarding this process, feel free to contact the City Clerk’s Office at (281) 420-6504.

Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field