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Blank P&Z Application City of Denton, TX Boards & Commissions Application Profile First Name Last Name Email Address Date of Birth: Home Address City State Postal Code Primary Phone Alternate Phone I am currently a City of Denton resident. r Yes r No Number of Years as a City of Denton Resident? What district do you live in? None Selected Do you require Reasonable Accommodations in order to perform the essential functions of the position? r Yes r No Have you ever served on a City of Denton board or commission? r Yes r No Please list the board or commission you have served on. If unknown, enter "Unknown", if not applicable enter N/A. Were you referred or nominated by a current council member of the City Council or another Official? * None Selected Page 1 of 2 Please provide their name or write N/A if not applicable. Which Boards would you like to apply for? Planning &Zoning Commission: Not Submitted What is your Social Security Number? What is your Drivers License Number? Type/Class: What state was it issued in? Acknowledgement Signature: *Type your full name as listed on this application. Page 2of2