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2. 
3. Application for Public Art Committee of the Cultural Advisory Board
   COMPLETED APPLICATIONS DUE April 9, 2018 at 11:59 PM MST
5. Office of Economic and Workforce Development . 807 E. Main Street, Suite 5-100 Durham, NC 27701 . 919 560 4965
7. For more information and to learn about committee duties, visit:
   Durham Public Art Program
8. For more information about the committee and the application process, please call or email Brian Smith at 919-560-4965 or [email protected]
12. Profile
14. Name*
15. Preferred Email Address*
17. Home Address*
19. City*
20. State*
21. Zip Code*
23. Primary Phone Number*
24. Mobile Phone
28. Employment
30. Employer
31. Occupation
33. Address
35. City
36. States
    -- Select One --ALAKASAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMHMAMIFMMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVAVIWAWVWIWY
37. Zip Code
39. Work Phone Number
41. Email Address
45. Board Selection
47. Board Selection
49. Are you currently serving on a City of Durham Board, Committee, or Commission?*

    1. Yes
    2. No
51. If yes, identify the board:
55. Qualifications & Experiences
57. Education and Areas of Study
59. Qualifications & Experiences
61. Based on your qualifications and experiences, describe why your service on the Public Art Committee of the Cultural Advisory Board would be beneficial to the City of Durham.
63. Other Information You Consider Pertinent (i.e. civic memberships, related experience, how you contribute to the diversity of the committee, etc.)
65. Upload a Resume
    Accepted file types: rtf, doc, docx, pdf, txt, jpg, jpeg, gif, png
69. Demographics
71. Are you at least 18 years of age?*

    1. Yes
    2. No

    Note: Up to three high school students may be considered for board service.
73. Do you live or work within the City Limits?*

    1. Yes
    2. No
75. Gender*
77. Ethnicity
    -- Select One --Asian/Pacific IslanderBlack/African AmericanHispanic/LatinoNative AmericanWhite/CaucasianMulti-RacialOther
81. Acknowledgement
83. Property tax listings must be current. City and county taxes must not reflect any delinquency at the time of submission of the application.
85. The application will be released to the public upon request.
87. Note: The application is active for one (1) year from the time of submission.
89. Applicants must adhere to the City's conflict of interest and social media use policies.
91. My initials acknowledge that all information is true and correct to the best of my knowledge. I've read and will commit to meeting most of the member expectations. *
Leave This Blank:


93. 1. Receive an email copy of this form.
94. Email address

    This field is not part of the form submission.

95. Submit Submit and Print

* indicates a required field