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2. Contact Information
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip*
13. Phone Number
14. Email Address
16. I am Interested In serving on the following board(s)

    1. Budget Review Committee
    2. Bluffdale Arts
    3. Bluffdale Youth Council
    4. Historic Preservation Commission

    1. Neighborhood Emergency Plan
    2. Rodeo Committee
    3. Miss Bluffdale Scholarship Pageant

    1. Healthy Bluffdale Coalition
    2. City Events
    3. Other (*explain below)
18. *Explanation
20. Please note any previous experience with community involvement and service (if any)
22. Please list reasons you are interested in participating on the board of choice
24. Please read and sign the Volunteer Release Form
    Volunteer Release Form
26. Date*
28. Signature*

30. Governmental entities must obtain and process only the minimum amount of personal data reasonably necessary to efficiently achieve a specified purpose, retained for required period. Utah Code § 63A-19-401(2)(c)

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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field