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2. Republic Housing Authority Application
   This application is for Republic Housing Authority residents interested in serving on the Republic Housing Authority Commission. The application is due to the City Clerk’s office on October 26, 2018, by 5:00 p.m. APPOINTMENT AUTHORITY/DUTIES: Appointment: The Republic Housing Authority Commission of the City of Republic consists of five (5) citizens appointed by the Mayor with the approval of a majority of the members of the City Council. Term of Office: This appointment will be to fulfill the term of Dorothy Craig which will be June 21, 2022. Qualifications: All members of the Commission shall be taxpayers who have been residents of the City for one year prior to such appointment. No commissioner may be an officer or employee of the city or county. A commissioner shall receive no compensation for his/her services for the authority, in any capacity; however, he/she is entitled to the necessary expenses, including traveling expenses, incurred in the discharge of his/her duties.
4. First Name
5. Last Name
7. Street Address
8. City
9. State
10. ZIP
12. Do you live in the city limits of Republic?

    1. YES
    2. NO
14. Cell Number
15. Home Phone Number
17. Email Address
19. 1. Why do you want to serve on the Housing Authority Commission?
21. 2. What is your view of the roll of this commission?
23. 3. Please list any civic and volunteer activities:
25. 4. Please tell us about your education:
27. 5. Is there additional information you would like the Mayor/City Council to consider regarding your application?
29. ACKNOWLEDGEMENT I have read and understand the statements on this form, and I hereby swear or affirm that the statements on this form are true and I understand the information on this form is open to the public.
31. Full Name
32. Today's Date
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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