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Commission Demographics

  1. Due to increased reporting requirements, the City of Moscow is required by federal and state laws and regulations to furnish statistical data on all commission applicants. You can assist us by completing the following information. Providing this data is voluntary and will not affect your opportunity for volunteering. Even if you decline to provide data, you are requested to put your name and signature on this form. This form will be used for EEO-4 and other federal government reporting purposes and will be kept separate from your application.

  2. Gender*
  3. Race / Ethnicity*
  4. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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