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2. Library Board of Trustees Details

   The Library Board of Trustees is responsible for reviewing information related to the operations of the Waukee Public Library. Members are appointed by the mayor for 3-year terms. Meetings are held on the second Tuesday of every month at 5:30 p.m. at the library.

6. First Name*
7. Last Name*
9. Full Legal Name*
11. Date of Birth*
    Date of Birth
13. Street Address*
15. Mailing Address (if different than above)
17. City, State and Zip
    Waukee, IA 50263 (Must be a Waukee resident)
19. Home Phone*
20. Email Address*
22. Business Phone
23. Cell Phone
27. Personal Information*
    Please type your gender into the box above. This form assists the Mayor and City Council in evaluating the qualifications of applicants for appointment to a board, commission or committee. State law requires political subdivisions to make a good faith effort to balance appointive boards, commissions, committees and councils authorized by the Code of Iowa according to gender.
29. Employment/Volunteer Work*
    Please list your place of employment and/or activities such as hobbies, volunteer work, etc. that you feel may qualify you for this appointment.
31. Your Interest*
    Please describe why you are interested in serving on the Library Board of Trustees
33. Supporting Information
    Please include any other information that supports your interest.
35. Your Contributions*
    What contributions do you feel you can make?
37. References*
    Please provide at least two references who may be contacted on your qualifications for this appointment. Please include name, address, phone number, email address and your relationship to them.
41. Signature*

    1. Signature

    I certify that there is nothing that would prohibit me from serving on the Waukee Public Library. My application will be retained for one year. This application is a public document and as such can be viewed, reproduced or distributed to the public.
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43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field