Forms • Hallandale Beach • CivicEngage

First Name *

Last Name *

Home Address *

City *

State *

Zip Code *

Telephone*

Email Address

If applicable, How long have you lived in Hallandale Beach?

Days Available to Attend Meetings:*

	Monday
	Tuesday
	Wednesday

	Thursday
	Friday

Hours Available to Attend Meetings:*

	Mornings
	Middays

	Afternoons
	Nights

Prior Work/Volunteer Experience:

Why Do You Want to Serve on a Board or Committee?

Please select in order of preference, among the following, a Board or Committee you are interested in serving as a member.

Please select in order of preference, among the following, a second Board or Committee you are interested in serving as a member.

Please select in order of preference, among the following, a third Board or Committee you are interested in serving as a member.

What special qualifications do you feel you would bring to this board or committee?

Your application may be considered for other Boards or Committees than those you selected above. If selected, would you be willing to serve on any other board or committee?*

Yes

No

Your application is valid for one year from the date submitted. During that time, it will be automatically submitted for any vacancies which may occur. You will not be contacted prior to each submittal. Is this acceptable?*

Yes

No

Please provide any additional information you feel would help the City Commission in appointing you to a Board or Committee:

* indicates required fields.

Live Edit

City of Hallandale Beach

Helpful Links

Using This Site

Disclaimer: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact the city by phone or in writing.