Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application for Appointment

  1. I am willing to serve on more than 1 authority board/commission/committee concurrently.
  2. Gender
    For Diversity Purposes
  3. For Diversity Purposes
  4. Home
  5. Business
  6. Are you a resident of the City of Roanoke?
  7. Are you a registered voter?
  8. Are your accounts current with the city?
  9. Are you over the age of 18?
  10. If so, please specify.
  11. Do you or does any member of your immediate family residing in your household hold a position, paid or unpaid, with any person or entity, or have a contract with or any obligation to any person or entity, which might constitute a conflict or a conflict-of-interest with the position for which you are applying?
    For purposes of this question, entity specifically includes, but is not limited to, the City of Roanoke and any entity which receives funds from the city.
  12. Criminal Information
  13. Have you ever been convicted of a law violation, including moving traffic violations, since your 18th birthday?
  14. Have you ever been convicted of a felony?
  15. Have you ever been convicted of a misdemeanor involving moral turpitude (any offense involving lying, stealing, or cheating) since your 18th birthday?
  16. Are there any criminal charges or proceedings pending against you?
  17. City Council requires a minimum of 75% attendance to all authority, board, commission or committee meetings. Pursuant to Section 2-283.1, Code of the City of Roanoke (1979), as amended, 3 consecutive unexcused absences may result in loss of membership. You will be notified by letter upon appointment. Prior to assuming your duties, an Oath of Office must be administered by the Clerk of Circuit Court or her designee, with a copy of the administered oath returned to the City Clerk's Office. If not selected, your application will remain on file in the City Clerk's Office for one year from the date of application, for consideration of future vacancies.
  18. Leave This Blank:

  19. This field is not part of the form submission.