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2. Per the Community Benefits Ordinance, the city shall select three people that attended the Community Participation Meeting and are recommended. 

4. Qualifications

   Must be a resident in the city

6. Name*
7. Email Address*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
17. Number of Years in the Community*
18. Ward You Live In
20. Education*
22. Occupation*
24. Employer*
26. Are you registered to vote in the City of Ypsilanti? *

    1. Yes
    2. No
30. Work/volunteer experience related to the board or commission:*
32. I understand that appointment to a City of Ypsilanti board or commission requires regular attendance at board meetings.*

    1. Yes
34. I hereby certify that all of the information above is true.*

    1. Yes
36. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
38. Electronic Signature
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field