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Hispanic Advisory Committee Application

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This form has been modified since it was saved. Please review all fields before submitting.

First Name*
Last Name*
Address*
Email
Home Phone Number
Work Phone Number
Cell Phone Number
Occupation
Name of Employer
Do you live in Newport News?*
1. yes
2. no
Do you work in Newport News?*
1. yes
2. no
Please select the age group that best describes you.*
1. Under 18
2. 18-34
3. 35-60
4. Over 60
Please select the highest educational experience attained.*
1. High School
2. Some College
3. In College
4. College Graduate
5. Graduate or Professional School
6. Post Graduate
Degree or Major
Certification or other Vocational Training.
Other skills or languages
Volunteer Experience and other Community Involvement
Please include dates.
The Committee currently meets quarterly in the evenings. Are you available to meet at this time?*
1. yes
2. no
Please select all areas in which you have previous experience.
1. Aging
2. Budgeting
3. Communications/Media
4. Counseling
5. Cultural Activities
6. Drug Abuse
7. Economic Development
1. Education Training
2. Environment
3. Fund Raising
4. Health
5. Interpretive Services
6. Law
7. Mental Health
1. Planning Management
2. Public Relations
3. Recreation
4. Transportation
5. Urban Concerns
6. Volunteer Services
7. Youth
Other Experience
Please select all areas in which you show an interest.*
1. Aging
2. Budgeting
3. Communications/Media
4. Counseling
5. Cultural Activities
6. Drug Abuse
7. Economic Development
1. Education Training
2. Environment
3. Fund Raising
4. Health
5. Interpretive Services
6. Law
7. Mental Health
1. Planning Management
2. Public Relations
3. Recreation
4. Transportation
5. Urban Concerns
6. Volunteer Services
7. Youth
Other Interests
As a member of the Hispanic Advisory Committee, how would your combined experience and expressed interests contribute to the entire Newport News community?*
Personal Statement or Résumé