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2. Application for Appointment to a Board or Commission

   Thank you for your interest in citizen participation in local government through membership on one of Clay County's Boards and Commissions. In order for your application to be considered, please fill in the following details. If you have a question or concern pertaining to your application, please call 816-407-3623.

   You will have the option to attach a resume or other supporting documentation to your application before submitting it.

   Applicants may be subject to a background check and completion of a Missouri Ethics Commission Financial Disclosure, as required for certain Boards and Commissions by the State of Missouri.

4. Application Regarding the following Board/Commission*

   Please note, only one option may be selected per submission.

   1. Airport Advisory
   2. Bicentennial Commission
   3. Board of Equalization
   4. Board of Zoning Adjustment (BZA)
   5. Building Codes Commission
   6. Citizens Academy Program
   7. Children's Services Fund Board
   8. Clay Platte Ray Mental Health

   1. Common Sewer District Board
   2. Developmental Disabilities Resources
   3. Domestic Violence
   4. Golf Complex Advisory
   5. Industrial Development Authority
   6. Mid-Continent Library
   7. Millennium Historical

   1. Parks Advisory
   2. Planning & Zoning Commission (PZC)
   3. Redistricting Commission
   4. Senior Citizens Board
   5. Tax Increment Financing (TIF)
   6. Tourism Board
   7. Workforce Investment Board
6. First Name*
7. Middle Name
8. Last Name*
10. Phone Number
11. Email Address
13. Current Residential Address*
15. City
16. State
17. Zip
19. Current Business Address (if applicable)
21. City
22. State
23. Zip
25. Specify your preferred mailing address

    1. Residential
    2. Business
27. What district do you currently reside in?

    1. Eastern
    2. Western
29. Upload Your Resume or Related Documents
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field