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2. The following information may be released to the general public pursuant to a Freedom of Information Act request.
4. First Name*
5. Last Name*
7. City Resident? (Please Select One)*

   1. Yes
   2. No
8. How long have you lived in the City of Charlottesville?
9. New Applicant?

   1. Yes
   2. No
10. Request for Reappointment?

    1. Yes
    2. No
12. Schools attended, degrees, graduation dates:
14. Memberships in fraternal, business, and/or social groups:
16. Public, civic and charitable offices and/or activities:
18. Interests aside from profession:
20. Reasons for wanting to serve on this board/commission:
24. The following information will be classified as personnel information pursuant to Virginia Code Section 2.2-3705.1 and the Council will not release this information to the general public pursuant to a Freedom of Information Act request.
26. Home Address
28. City
29. State
30. Zip Code
32. Previous Residence
34. City
35. State
36. Zip Code
38. Occupation & Title
39. Employer:
41. Business Address
43. City
44. State
45. Zip Code
47. Phone Number*
49. Email Address*
51. Upload your resume (optional)

53. Mailing Address
    Parks and Recreation Director
    PO Box 911
    Charlottesville, VA 22902

    Phone
    Main Office: 434-970-3620
    Fax: 434-970-3596

    
    

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55. 1. Receive an email copy of this form.
56. Email address

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57. Submit

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