Citizen Interest Application

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Thank you for your interest in serving your community. We encourage citizens to volunteer to serve on our Boards, Committees and Commissions. This application will be kept on file for three (3) years from the date received, and will be considered when vacancies occur on the committee(s) for which you applied.

Women and minorities are encouraged to apply.

Please note that information provided is subject to the open records laws of the State of South Dakota. If recommended by the mayor, your appointment is subject to City Council confirmation.

Any questions can be directed to the Mayor’s Office at 605-394-4110.

Thank you for applying.

Note: Click here to view a map of the Rapid City voting wards.

Fields marked with * are required

Name:

Street Address

City, State, Zip Code

Phone Number:

Email:

Title/Occupation:

Employer:

Employer Street Address:

Employer City, State, Zip Code:

Employer Phone:

Employer Email:

At which address would you prefer to be contacted?

Home Work

Ward:

I would like to serve on the following:

I am also interested in serving on:

Please list education or training relevant to your choice(s):

Please list work experience relevant to your choice(s):

Please list community volunteer service relevant to your choice(s):

I would like to serve in the indicated position(s) because:

Primary Reference Name:

Primary Reference Address:

Primary Reference Phone:

Secondary Reference Name:

Secondary Reference Address:

Secondary Reference Phone:

Are you a registered voter of Rapid City?

Are you a resident of Rapid City?:

I understand the role and responsibility of membership on these Boards or Commissions and am willing to serve. In applying for appointment, I understand that the mayor may contact the references listed. I also understand that I might be contacted by citizens or other board members at the address I indicated on the other side of this application.

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