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The Village of Hazel Crest |
708.335.9600 |
Thank you for your willingness to serve as
a community volunteer. The following information will assist us in
ascertaining
the best position for you to utilize your experience,
abilities and interests. Please attach a resume.
_________________________
Date
_________________________________________________________________________________________________
Name
_________________________________________________________________________________________________
Address Email Address
_________________________________________________________________________________________________
Daytime Phone Number Evening Phone Number
Years as a Hazel Crest Resident _______________ Home Owner Renter
Years as a Hazel Crest Business Owner: _________________
From the attached list, please indicate (in order of preference) the
community activities you would be interested in
participating in or
learning more about.
1. ______________________________________________________________________________________________
2 ______________________________________________________________________________________________
3. ______________________________________________________________________________________________
Availability
Check here if you might be open to serving on any other committee that matches your interests or skills.
Please indicate your availability on a regular basis:
Anytime (as needed) Weekly Semi-Monthly Monthly Intermittently
Please indicate prior evening commitments:
Mon. Tues. Wed. Thurs.
1st Wk. 2nd Wk. 3rd Wk. 4th Wk.
Employment Activity
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Educational Data
_________________________________________________________________________________________________
Degrees (if any)
_________________________________________________________________________________________________
Other Educational Experience
Community Activities, Professional Organizations or Other Interests:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Please complete the following:
A. Particular qualifications for the appointments you are interested in (please use 1, 2,3 in descending order):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
B. Work experiences related to the appointment you are interested in (please use 1, 2,3 in descending order):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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C. Periodically, the Village may convene a committee on a temporary basis for a specific project. Do you possess any special skills that could be applied to a specific project (i.e., health care, benefits administration, human resources, economic development, communications, technologies?)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Please Returned Completed Form to:
Village Clerk
Village of Hazel Crest
3000 W. 170th Place
Hazel Crest, IL 60429
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