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Application for City Boards / Commissions / Committee

  1. Names and phone numbers

  2. I am interested in serving:

    Please check one or more

  3. Is this an application for reappointment?

  4. We welcome your willingness to serve Bremerton. For more information please contact the Mayor's Office by phone at 360-473-5266, by fax at 360-473-5883, or via email.

    Pursuant to the Washington Public Disclosure Act, (RCW 42.56), this form constitutes a public record and is subject to public release upon request. Prior to release, the following information may be redacted pursuant to RCW 42.56.250(3): Residential addresses, residential telephone numbers, personal wireless telephone numbers, personal electronic mail addresses, social security numbers, driver’s license numbers, identicard numbers, and emergency contact information of employees or volunteers of a public agency, and the names, dates of birth, residential addresses, residential telephone numbers, personal wireless telephone numbers, personal electronic mail addresses, social security numbers, and emergency contact information of dependents of employees or volunteers of a public agency.

    Applicants are considered for appointment without regard to race, color, religion, gender, national origin, sexual orientation, age, genetic information, marital or veteran status, or the presence of any disability.

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  6. This field is not part of the form submission.