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2. Advisory Board Application

   The City of Stuart recognizes that citizen participation is vital to a customer-oriented government. The City also recognizes the unique contributions made by volunteers and encourages involvement in the policy-making process through service as an Advisory Board Member.

4. Full Name*
6. Home Phone*
7. Cell Phone*
9. E-Mail
11. Home Address, City, Zip*
13. How Long? Years & Months.
15. Current Employer/Occupation
17. Business Address
19. Brief Summary of Education & Work Experience. (Please attach a resume if available.)
21. If applicable, attach resume here.
23. Membership in Community Organizations or Professional Groups
25. List Former Advisory Board(s) Affiliations
27. Why do you wish to serve on the board(s) indicated?
29. Are you currently a registered voter in Martin County?*
    -- Select One --YesNo
31. Are you part of a protected class that requires your personal information be redacted from public view?*
    -- Select One --YesNo
35. The following criteria will be verified by the City upon appointment
    1. Members must be current residents of the city of Stuart or be property owners of real estate within the City limits.
    2. Members shall be over the age of 18.
    3. Member shall be appointed to fill specific one-year terms of board membership.
    4. Not been convicted of a felony.
37. Do you meet all the requirements above?*
    -- Select One --YesNo
39. Please identify by placing a check mark on the board(s) of your choice:

    (Please note that membership on more than one standing board is prohibited)

    1. Community Redevelopment Board
    2. Local Planning Agency/Planning Advisory Board
    3. Board of Adjustment
    4. Stuart Independent Review Board
    5. East Stuart Historical Advisory Committee
41. The Florida Department of State requires that the City report the number of minority appointments made during the year. (Section 760.80, Florida Statutes)

    Please select which applies to you:

43. Gender*

    1. Female
    2. Male
44. Race*

    1. African American
    2. Asian American
    3. Caucasian
    4. Hispanic American
    5. Native American
45. Disability*

    1. Not Known
    2. Physically Disabled
47. NOTE:

    Board Members that belong to the Community Redevelopment Board (CRB), Local Planning Agency (LPA), and Board of Adjustment (BOA) are required to complete an annual Financial Disclosure Form reporting to Florida Commission on Ethics. In addition, a background check will be processed prior to final appointment.

49. OTHER

    APPLICATIONS WILL REMAIN ACTIVE FOR ONE YEAR FROM DATE OF RECEIPT.

    MEMBERS WILL BE NOTIFIED WITHIN 5 BUSINESS DAYS OF APPOINTMENT.

    Applications may be submitted via e-mail, regular mail, or in person:

    City of Stuart, Attention: City Clerk's Office
    121 SW Flagler Avenue, Stuart, FL 34994
    Phone: (772) 288-5304 Website: www.cityofstuart.fl.us

    
    

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51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field