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Application for Boards, Authorities, and Commissions - Mayoral Appointment

  1. This application will be utilized in considering you for appointment by the Mayor to various boards and advisory committees. Pursuant to Florida Statutes, Chapter 119, all information provided on or with this form becomes a public record and is subject to disclosure, unless otherwise exempted by law.

    Completed applications will be kept on file for a period of one (1) year from the date received in the Office of the City Clerk.

    If you have any questions, contact the City Clerk’s Office.
  2. Personal Information
  3. To which address do you prefer we send correspondence regarding this application?
  4. Details
  5. Are you a City resident?*
  6. Do you own property within the City limits?*
  7. Are you a registered voter in the city?*
  8. Do you currently serve on a board?*
  9. Do you currently hold a public office?*
  10. Would you be willing to resign your current office for the appointment you now seek?*
    The Florida Constitution, in section 5 (a) of Article II, prohibits simultaneous “dual office holding”. If you were already serving on a board, authority, or commission for the City of Pensacola or for another governmental agency, would you be willing to resign in order to accept the appointment you now seek?
  11. Diversity
    In order to encourage diversity in selections of members of government committees, the following information is required by Florida Statute 760.80 for some committees.
  12. Acknowledgement of Terms*
    I hereby certify that the statements and answers provided are true and accurate. I understand that any false statements may be cause for removal from a board or committee if appointed.
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  14. This field is not part of the form submission.