First Name*  
                                
            
                Last Name*  
                                
            
                Email Address*  
                                
            
                Phone*  
                                
                            
            
                        
            
            
                            
                    Cover Letter*  
                    
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
                            
                    Salutation/Prefix*  
                    -- No answer -- Mr. Mrs. Ms. Mx. Admiral Captain Colonel Commander Commissioner Director Dr. General Hon. Lieutenant Officer Prof. Rabbi Rear Admiral Rev. Sergeant 
                            
                    Boards and Commissions members are appointed by Mayor Bowser and serve as members of the Bowser Administration. Please tell us why you're interested in being appointed by Mayor Bowser and serving in her administration.*  
                                    
                            
                    Please explain why you are interested in and particularly suited to serve on this DC board or commission in the Bowser Administration.*  
                                    
                            
                    Many boards and commissions have seats designated for people with specific expertise or experience. Of the public member seats appointed by the Mayor and listed in the posting as designated for individuals with specific expertise or experiences (if any), which would you like to be considered for?*  
                                    
                            
                    Most District of Columbia Boards or Commissions are VOLUNTEER boards with community members seeking to engage in civic participation being appointed to non-paid positions serving our District communities. Unless specifically stated, this is a VOLUNTEER position.   *  
                    -- No answer -- Yes, I wish to serve and understand this is a volunteer role. No, I do not wish to serve in this volunteer role. The posting indicates that this is a paid board. 
                            
                    Are you a DC resident?   *  
                    -- No answer -- Yes No 
                            
                    Are you currently an employee of the District of Columbia government?  *  
                    -- No answer -- Yes No 
                            
                    If yes, what agency and role? 
                    
                            
                    Are you a registered lobbyist?  Please note several DC Boards and commissions do not allow lobbyists to serve.*  
                    -- No answer -- Yes No 
                            
                    Education and General Qualifications (this information is needed for classification)  Please check the highest level attained*  
                    
                            
                    Are you registered to vote in the District of Columbia?*  
                    
                            
                    What is your political affiliation? (for several boards and commissions, a balance between political parties is required)*  
                    
                            
                    Are you a current employee of the US government?*  
                    
                            
                    Are you or a family member currently serving on a DC board or commission?*  
                    
                            
                    If yes, please list all commissions/boards. 
                                    
                            
                    Are you currently an Advisory Neighborhood Commissioner (ANC)?*  
                    -- No answer -- Yes No 
                            
                    Diversity and Inclusion:  What is your date of birth?*  
                    
                            
                    Diversity and Inclusion:  Our Boards and Commissions must reflect the diversity of District residents.  Please check all that apply related to race/ethnicity.*  
                    
                            
                    Diversity and Inclusion:  Our Boards and Commissions must reflect the diversity of District residents.  Please check all that apply related to gender.*  
                    
                            
                    Diversity and Inclusion:  Please check all that apply. 
                    
                            
                    Diversity and Inclusion:  Mayor Bowser is committed to appointing residents from all 8 wards of Washington, DC to boards and commissions.  In which do you currently reside?   NOTE:  residency is required for most boards and commissions, and strongly preferred for all appointments.*  
                    -- No answer -- Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6 Ward 7 Ward 8 Maryland Resident Pennsylvania Resident Virginia Resident West Virginia Resident Other 
                            
                    Ethical considerations *  
                                    
                            
                    Ethical Considerations *  
                                    
                            
                    Please upload your resume. 
                    
                            
                    Please attach a brief biographical statement (similar to a speaker's biography) that outlines your professional history, experiences, and education.*  
                    
                            
                    Please upload a headshot or similar photo.*