Volunteer Fact Sheet

City of Franklin
9229 W. Loomis Road
Franklin, WI  53132
414-425-7500
414-425-6428 (Fax)
 

 

Thank you for your interest in serving on a City Board, Commission, or Committee.  In order that consistent information be provided to the Common Council, you are asked to complete the following:

 

Personal Information:

Name   

 
 

Address     
 
Phone Number     
 
Email Address     
 
Years as a Franklin resident     
 
Alderman or District No. (if known)   

Area of Interest:


Please check the box next to the Board, Commission, or Committee of greatest interest.  If checking more than one, please prioritize your top three choices in the space given below, listing the first as top priority and so on.

  Architectural Review Board      Civic Celebrations Commission 
  Community Development Authority      Economic Development Commission 
  Environmental Commission      Finance Committee 
  Fair Commission      Board of Health 
  Fire and Police Commission     Parks Commission 
  Library Board      Plan Commission 
  Personnel Committee      Board of Review 
  Board of Public Works      Quarry Monitoring Committee 
  Technology Commission      Tourism Commission
  Board of Zoning & Building Appeals      Waste Facilities Monitoring Committee
  Board of Water Commissioners    

 

   

If more than 1 box is checked above, please prioritize your choices listing the first as top priority and so on:

   

Why are you interested in joining this (these) particular Board and/or Committee/Commission?

 

Volunteer or Work Experience:


Begin with your most recent employment and continue with all past 10 years of employment.

Job 1 

Company Name

   
Address
 
   
Telephone
 
   
Start Date / Position
 
   
End Date / Position Upon Leaving 
 
   
Description of Duties     

Job 2

Company Name

   
Address
 
   
Telephone
 
   
Start Date / Position
 
   
End Date / Position Upon Leaving 
 
   
Description of Duties     

Job 3

Company Name    
Address
 
   
Telephone
 
   
Start Date / Position
 
   
End Date / Position Upon Leaving 
 
   
Description of Duties     

 

Additional Experience of Qualifications:


List any other experience, skills, or other qualifications (including hobbies) which you believe should be considered in evaluating your qualifications for volunteering. 

 


 


I am aware that all of the information provided and this document itself is a public record which will be released to a requestor; that I authorize such release and that I waive any right to any notice of such release and/or any right of notice to augment the information provided upon this document upon such request or release.


Signature                                           Date  


NOTIFICATION & AGREEMENT


I certify that the information provided by me in this Application is true and complete to the best of my knowledge.  I understand that if I am appointed, any false statements or omissions can be cause for reconsideration or termination of the appointment.

The City of Franklin is hereby authorized to verify the information I have supplied and to conduct any review or investigation of my personal history.  By signing below I also authorize the City of Franklin and it's assigns to perform a background check on all information provided by me on this application, including but not limited to, information related to past or pending criminal charges, past criminal convictions, education and employment history, and the status of property tax, fines, and fee payments I owe the City.  I further authorize any holder of information pertaining to the information supplied by me on this application to release such information to the City, which shall remain confidential to the extent provided for pursuant to Wisconsin law.  I understand and agree that the City shall not be held liable in my respect for any actions taken by the City to check such information.  I further understand and agree that the record of the information obtained during the background check is a public record and is subject to release upon a request for the record, subject to the considerations to be made under and the application of the Wisconsin open records laws.

It is the intent of the City of Franklin to comply with all state and federal requirements and to operate within the law in the implementation of all facets of equal opportunity and affirmative action.  In the recruitment, selection, utilization, or termination of Board and Commission appointments, there will be no discrimation on the basis of race, color, religious belief, age, gender, sexual orientation, national origin, citizenship status, disability, marital status, pregnancy.  Do not include information of this nature in the application.  It is the City of Franklin's intention that all qualified applicants be given equal opportunity and that selection decisions be based on position-related factors.

I understand that should a Board or Commission appointment offer be extended to me and accepted I will be subject to and will fully adhere to the policies, rules, and regulations of the City of Franklin and State of Wisconsin, including but not limited to those related to ethical standards, public records, and public meetings.


Signature                                           Date
 

Applications are kept on file for 2 years.