RequestTracker Forms • Pella, IA • CivicEngage

The City of Pella appreciates your interest in serving the community and welcomes your application. Please complete all sections of this application. If you have any questions, please contact the City Clerk's office at 641.628.4173. The City of Pella is committed to providing equal opportunity for citizen involvement.

For more information on each committee visit the Boards and Commissions page.

Boards & Commissions

Are you a resident of Pella? *

Yes

No

Please indicate those Boards and/or Commissions on which you would be willing to serve. *

Name: First, Middle Initial, Last*

Street*

City*

Zip Code*

State

Email:

Phone Number:*

Occupation:

Gender:*

Male

Female

Please indicate the reasons why you would like to be appointed to a Board or Commission and any specific skills or experience that you believe support your application. *

Date:*

Signature:*

Submitting an application through this website constitutes your electronic signature. Any record
containing an electronic signature shall be deemed for all purposes to have been “signed” and will constitute an “original” when printed from electronic records established and maintained by the City in the normal course of business.

* indicates required fields.

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