2. First Name*
3. Last Name*
5. Address*
7. Postal City*

   1. Delafield
   2. Hartland
8. Email*
10. Day Phone*
11. Night Phone*
13. Place of Employment
15. Occupation
17. Are you a City resident?*

    1. Yes
    2. No
18. Are you a registered voter?

    1. Yes
    2. No
20. What District do you currently live in or who is your current Alderperson?
22. Appointment Preference

    1. Board of Zoning Appeals (2nd and 4th Thursday - 6:00pm)
    2. Board of Review (as needed) - typically 4pm to 6pm
    3. Common Council (see schedule online - 7:00pm)
    4. Deer Management (TBD - time TBD)
    5. Del-Hart Commission (3rd Tuesday odd months - 5:00pm)
    6. Lake Welfare (2nd Wednesday - 6:00pm)
    7. Library Board (2nd Tuesday - 6:30pm)
    8. Park & Recreation (4th Monday - 6:00pm or 5:30pm for Tree Board)
    9. Plan Commission (Last Wednesday - 7:00pm)
    10. Police Commission (as needed - 5:30pm)
    11. Promotion & Tourism Commission (2nd Tuesday - 7:30am)
    12. Public Works (1st Wednesday - 6:30am)
24. Have you ever served as a member of any City of Delafield Common Council, Board, Committee, or Commission?

    1. Yes
    2. No
26. If Yes, which group and approximately when?
28. Please describe your expertise, experience, or interest in joining the common council, board, committee, or commission.
32. By submitting this form, I understand that my attendance at all regularly scheduled meetings is critical and that the Mayor may appoint a replacement for members who are chronically absent from regular meetings. I hereby certify that I have not been convicted of a felony (unless duly pardoned).
34. All applications are kept on file for one year. During that time, your application will be considered when there is an opening for the Common Council, Board, Commission, or Committee for which you have applied. *Note: You must reside within the City of Delafield to be considered for appointment.
36. Please notify the Clerk’s Office at 262-646-6220 if you move or no longer wish to be considered for appointment.
40. Additional Information
    Please feel free to attach a resume and/or copies of any certificates pertinent to the appointment you are seeking.
42. You can also mail or deliver your application to: City of Delafield, 500 Genesee Street, Delafield WI 53018
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field