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2. Name of Board or Commission You Are Applying For
4. First Name
5. Middle Initial
6. Last Name
8. Address
10. City
11. State
12. Zip Code
14. Daytime Phone Number
15. Evening Phone Number
16. Email Address
18. Occupation
20. Are you a permanent resident of North Myrtle Beach?

    1. Yes
    2. No
21. If so, how long have you been a permanent resident?
23. List your qualifications for this Board:
25. List the reason why you would like to serve on this Board/Commission:
27. Have you served on any other Board/Commission for the City of North Myrtle Beach?

    1. Yes
    2. No
28. If so, which one and when?
30. Please feel free to attach your resume or any other documents you would like to include with this application.
Leave This Blank:


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

    This field is not part of the form submission.

34. Submit

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