I understand that this application will be kept in active status for one year from date of application.

I certify that the information provided in this application is true and correct to the best of my knowledge. I authorize and consent to background checks and to the investigation and verification of all information contained herein. I further authorize all persons having information concerning my qualifications to release information to city representatives and release such persons from all liability for any damages connected with the release of such information. I also release and discharge the City of Monroe from any claims and damages, losses, liabilities, costs, expenses or any other charges or complaints arising out of the City's use of any information provided pursuant to this release. I understand and agree that any misstatement will be cause for my removal from any board or committee. By submitting this application, I agree to adhere to all city policies pertaining to boards and commissions, including attendance. I hereby acknowledge that this application and information provided herein may constitute a public record, pursuant to North Carolina’s Public Records Law, N.C.G.S. 132-1, et. seq., and as such, may be released in accordance with all applicable public record laws.