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2. Name of Commission/Board/Committee
4. Nominated By
6. Name
7. Phone
9. Email Address
11. Physical Address
13. Mailing Address (If different than physical address)
15. Employer
16. Position/Occupation
18. Business Phone Number
19. Fax
21. I reside:

    1. Inside Wimberley’s City Limits
    2. Wimberley’s ETJ
    3. Outside ETJ
22. I am a registered voter in:

    1. City of Wimberley
    2. Hays County
    3. Not Registered
24. Do you or your employer have any business or other dealings with the City of Wimberley, which might present a conflict of interest?

    1. Yes
    2. No
26. If "Yes," please explain
28. Are you committed to devote the necessary amount of time to service on this Commission/’Board/Committee and to attend all regularly scheduled meetings?

    1. Yes
    2. No
30. Would you consider serving on a different Commission/Board/Committee?

    1. Yes
    2. No
32. Qualifications

    Describe any qualifications, expertise, credentials, or special interests that relate to your possible appointment. If you are not responding to a specific advertisement, please indicate the Commission/Board/Committee that you would prefer to serve on.

34. Name as Signature
35. Date
    Date
37. Note:

    Your application will be kept on file for 12 months and maintained under the Texas Open Records Act as public information. It is recommended that you submit a letter of interest and a brief resume with your application. Please submit any information to the City Secretary via email or at the City of Wimberley Administration Office, located at: 221 Stillwater Wimberley, TX 78676

39. Letter of Interest
40. Brief Resume
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field