Amarillo 101 Application Form:

Amarillo 101’s mission is to familiarize citizens with the structure, function and purpose of Amarillo city government. It also strives to equip and encourage citizens to assume a leadership role within the community. Applicants must live or work in Amarillo.

 

 
* Full Name:
* Date of Birth:
Month Day Year *
Gender:
Male Female
Years Living or Working in Amarillo:
* Street Address:
City:
* Zip Code:
* County:
   
Home Phone:
Work Phone:
* Cell Phone:
* Primary Email Address:
* Employer:
* Occupation/Title:
How did you learn about Amarillo 101?
* Have you applied for Amarillo 101 in the past?
Yes No
If you answered yes, please put when you applied previously.

Please list any community, professional or other organizations in which you have been an active member. If new to Amarillo, you may include activities from your previous location.

Organization#1:
Organization:
Years of Involvement:
Position Held:
Organization#2:
Organization:
Years of Involvement:
Position Held:
Organization#3:
Organization:
Years of Involvement:
Position Held:
Organization#4:
Organization:
Years of Involvement:
Position Held:
Organization#5:
Organization:
Years of Involvement:
Position Held:
*Why are you interested in participating in Amarillo 101?
* Please Verify:
I am able to commit to attending the sessions

I am not currently holding or running for a Place on Amarillo City Council.

I allow the use of photographs

Please submit this application by Monday, August 10. Applicants will be notified no later
than Monday, August 24, if they are chosen for the Fall 2015 session of Amarillo 101.

City of Amarillo, Office of the City Manager
P.O. Box 1971
Amarillo, TX 79105-1971
or fax to 806.378.9394

* = Required Field