CITIZEN
INTEREST APPLICATION
NAME: _____________________________________________________
(First) (MI) (Last)
Current Address:
_________________________________________________
(Street) (City,
State, Zip)
Telephone:
_____________________________________________________
(Home) (Work)
E-mail
Address:
_________________________________________________
City Resident: ( )
Yes ( ) No
Amount of time available: _______________________________________
_____________________________________________________________
Educational Experience: ________________________________________
_____________________________________________________________
Community Involvement/Activities/Service
Organizations: ____________
_____________________________________________________________
_____________________________________________________________
The Board of Trustees Meeting is the 2nd Wednesday of each month at 5:15
p.m.
Are you available to meet at that time?
______ Yes ______ No
If no please list alternative times: ____ mornings ____ afternoons
____ evenings ____weekends
Best days of the week: _____________________________________________
Committee meetings are held during the noon hour on Monday once a month
or as needed. Are you available to meet during Monday over a lunch meeting?
___Yes. ____No. If no please state an alternative time ___________________
Library Service Issues/Needs you perceive:
Goals for yourself as a RCPL Library Trustee:
RCPL Board Profile Grid: - (please fill out the attached form and return
with this application)
____ Other – Please describe any other skills/talents you have that you
feel
might benefit the
library.
________________________________________________________________
Signature
Date
Please
return to the Library Business Office. This form will also be forwarded to the
Mayor’s Office.
If you have questions, please contact the Library
Director at 394-4171 or the Mayor’s Office at 394-4110. All applicants will be
kept on file for consideration when a vacancy occurs.