Form Center

2. Westfield residents are invited to complete the following application to serve on a Board or Commission in the City of Westfield. Questions regarding the application process may be directed to Email Marla Ailor at 317-804-3029.

4. Date
   Date
6. Name*

   First Name

7. Last Name

9. Email*
11. Primary Phone*
12. Other Phone
14. Address*

    Address Line 1

15. Address Line 2

17. How many years have you been a Westfield resident?*
21. Education
23. Name of the High School Attended*
24. Did you graduate?*

    1. Yes
    2. No
26. Name of Undergraduate College
27. Did you graduate?

    1. Yes
    2. No
29. Name of Post Graduate College
30. Did you graduate?

    1. Yes
    2. No
32. Name of Trade/Technical School
33. Did you graduate?

    1. Yes
    2. No
37. General Questions
39. Occupation*
41. Please check up to three (3) boards or commissions for which you are interested in serving*

    1. Advisory Plan Commission
    2. Board of Public Works & Safety
    3. Board of Zoning Appeals
    4. Civilian Fire Merit Board
    5. Community Development Corporation
    6. Economic Development Commission
    7. Facade Improvement Grant Committee
    8. Impact Fee Review Board
    9. Liquor License Review Committee
    10. Mayor's Council on Disabilities
    11. Preservation Commission
    12. Redevelopment Authority
    13. Redevelopment Development Commission
    14. Riverfront Liquor License Review Board
    15. Westfield Building Corporation
    16. Westfield Economic Foundation
43. Have you ever been involved with a neighborhood association, special interest group, or other volunteer group engaged in serving members of a community? If so, please provide details.*
45. Why are you applying to serve on a board or commission?*
47. What are the qualities you believe you possess that make you an ideal candidate for the Commission's role(s) for which you are applying?*
49. Certain Board/Commission roles may require a police background check. Would you be willing to undergo a Westfield Police Department criminal background check?*

    1. Yes
    2. No
53. Sign & Submit
55. Electronic Signature Agreement

    Agreement of Terms & Electronic Signature - By checking the box below and submitting the form you are acknowledging the truthfulness of your answers and further certifying that checking the box counts as an electronic signature. Your electronic signature is considered legally binding and is the same as signing your physical signature by hand (IC 26-2-8).*

    1. I agree.
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field