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2. Advisory Committees and Commission Application

   Any questions may be directed to our Deputy City Clerk, Claudia Ettesvold, (952) 443-4216 or cettesvold@ci.victoria.mn.us.

4. I am applying for:*
   -- Select One --Planning Commission (3-year term)Parks & Recreation Committee (3-year term)Senior Advisory Committee (3-year term)

   (choose the committee/commission you are interested in applying for)

6. Contact Information
8. First Name*
9. Last Name*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Phone Number (home or cell)*
20. Email*
22. Name of Employer and Occupation, or Retired*
24. Educational Background (Schools Attended/Attending):*
26. Tell us about yourself
28. Why are you interested in serving on a City advisory committee or commission?*
30. What contributions do you feel you can make to the committee/commission?*
32. What experience or interests do you have that make you a good candidate for a committee/commission?*
34. Please list any special qualifications you have that you feel are relevant for the committee/commission. (i.e. certifications, professional or personal membership organizations, etc.) *
36. Please list your role in, and describe any civic or community activities/service organizations for which you are involved.*
38. How long have you lived in Victoria and where did you live prior to moving to Victoria?*
40. How did you find out about the committee/commission openings?*
42. Tennessen Warning

    Please take notice that any data received by the City as the result of submitting this form will be classified as government data pursuant to the Minnesota Government Data Practices Act, Minnesota Statutes Chapter 13. Under the Data Practices Act, some or all of this data is classified as public data, including your name, address, email address, phone number, and other personal information provided by you. Public data is available to anyone requesting it and consists of all data furnished via this Web form. Please be advised that the correspondence will be added to the public record. The purpose and intended use of the information collected through this form is to obtain public input and data in support of City activities and services. You have the right to refuse to submit this form. If you choose not to submit this form, you will need to contact the City by another means if you wish to provide the information collected by the form.

44. Thank you for your interest in making the City a better place to live and work!

    We will be in contact with you once the applications have been reviewed.

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46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field