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Click Here for a (PDF) version of this form.  Your application may be hand-delivered or mailed to the City Clerk's Office at 300 West Thirteen Mile Road, Madison Heights, Michigan  48071.  You may also fax your completed application to the City Clerk at (248) 588-0204.  As a more convenient alternative, you may complete and submit our online application (below), which will be sent automatically to the Clerk's Office.

NOTE YOU MUST ALSO SUBMIT INFORMATION FOR A BACKGROUND CHECK WHEN APPLYING ONLINE.  CLICK HERE FOR BACKGROUND APPLICATION.
APPLICATION FOR BOARDS AND COMMISSIONS

Thank you for your interest in serving on an Advisory Board or Commission. The purpose of this form is to provide the Mayor and Council with basic information about persons being considered for appointment. This application will be kept on file for ONE YEAR. The file of completed applications is open for public inspection upon request. Please note that the background information is NOT open to public inspection
Date:

Last Name: First Name:
Street Address:
City: State: Zip:
Home Phone: Business Phone:
Date of Birth: E-Mail Address:
Employer:
Employer Address:
Employer City: Employer State: Employer Zip:
 
Are you a Registered Voter in Madison Heights?   
 
Educational Background:
Professional Qualifications and/or Work Experience:
Community Activities and / or Work Experience:
List the Advisory Board or Commission for which you would like to apply, in order of preference:
Preference #1

Preference #2

Appointment to the Planning Commission will require you to resign from all other Boards/Commissions. (Code of Ordinances Section 2.109 and MCL 125.33(3)).