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Board and Committee Membership Application

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  2. City Manager's Office
    City Hall, 2nd Floor
    400 Washington Street
    Burlington, Iowa 52601

    Questions? (319) 753-8120

  3. Thank you for your interest in serving on a Burlington Committee or Board. The purpose of this form is to provide the City Council members with information about residents considered for appointment.

  4. Effective January 1, 2012, Section 69.16A of the Iowa Code requires gender balance on those City Boards and Commissions required or governed by state law unless the City has made a good faith effort to appoint a qualified person for a period of three months. The City Council of Iowa City has initiated the process of gender balance and has applied the process to all City Boards and Commissions.

  5. Please check when available for meetings*

  6. Check each Board/Commission that you have interest in serving on:*

  7. Leave This Blank: