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Mayoral Appointment Application Form

2. First Name*
3. Last Name*
5. Address*
7. City*
8. State*
9. Zip*
11. Primary Phone Number*
12. Secondary Phone Number
14. Email Address
16. Occupation/Title
18. Background experience and education that may be related to your service:
20. Reasons you are interested in serving the City of Verona through an appointment:
22. Other organizations, committees, or community activities that you have been involved with:
24. Are you currently or have you previously served on a City of Verona board or commission?*

    1. Yes
    2. No
26. If yes, which?
28. Resident of the City of Verona since:*
30. Which board(s) or commission(s) are you interested in serving on?*

    1. Community Development Authority (meets as needed)
    2. Fitch-Rona EMS Commission (meets the third Thursday of the month at 7:00 p.m.)
    3. Library Board (meets the first Monday of the month at 6:30 p.m.)
    4. Park, Recreation, and Forestry Commission (meets the third Wednesday of the month at 7:00 p.m.)
    5. Plan Commission (meets the first Monday of the month at 6:30 p.m.)
    6. Police and Fire Commission (meets as needed)
    7. Zoning Board of Appeals (meets as needed)
    8. Cemetery Commission (meets as needed)
32. Applications may be submitted at any time and will be kept on file for consideration at reappointment time or when vacancies occur.
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print | Go Back