Boards and Committees Application Form

Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

PLEASE SELECT THE BOARD(S) COMMITTEE(S) ON WHICH YOU ARE INTERESTED IN SERVING

Mark the boards on which you are interested in serving. (A description of each board’s responsibilities can be found on its page on the City’s website.)

Are you a resident of Clewiston? Yes or No

Are you a registered voter in Clewiston/Hendry County, FL? Yes or No

Are you currently serving on a City Board? Yes or No

Have you ever served on a City Board/Committee? Yes or No

If so, please indicate the Board(s)/Committee(s) and Date of Service

Are you willing to attend monthly board meetings? In Person Yes or No

I understand any member absence from three (3) consecutive meetings will be considered as resignation from the board/committee

Yes

Please list any special talent, qualification, education, or professional experience that would contribute to your service on the Board/Committee you have selected?

Please summarize your volunteer experience(s):

Florida law requires appointed members of the Planning and Zoning Board and the Community Redevelopment Advisory Board (CRA) to file a Form 1 – Statement of Financial Interests Disclosure annually.

Vetting by the City Clerk. The City Commission will review and vote as a Board at a City Commission Regular Meeting. I hereby certify that the statements and answers provided are true and accurate to the best if my knowledge.

First

Middle

Last

Date

Attach Resume

One file only.
256 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

To All Applicants:

The City Commission of the City of Clewiston adopted Resolution No. 2025-06– Advisory Board and Committees Appointment Process Policy that all applicants are to complete and sign a background Investigation waiver form authorizing the City of Clewiston Police Department to conduct a simple background investigation, which consist of employment history verification, affiliations and memberships, financial/credit report, and any criminal convictions. Please complete the attached Authority For Release of Information Form. This form must be signed in the presence of a notary and notarized.

Statement of Financial Interests Disclosure Form

One file only.
256 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

Authority For Release of Information Form

One file only.
256 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.