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City Code requires prospective and existing board members to fill out an application, consent to a standard criminal background check*, be duly registered to vote in Brevard County, and be a resident or an owner of real property in the City of Cocoa. City Code also prohibits a person from serving on a City Board or Committee if that person has been convicted of a felony, unless their
civil rights have been restored.
Please select the district that you live in. This information can be found on your Voter's Registration card.
The information being requested is necessary in order to conduct a background check. Information will be used for those purposes only.
(Please Check All Those That Interest You)
Section 760.80, Florida Statutes, requires that the City annually submit a report to the Secretary of State disclosing race, gender, and physical disabilities of board and committee members. Please check the
By filling this application with the City of Cocoa, I do hereby acknowledge the following:
1. This application, when completed and filed with the Office of the City Clerk, is a public record under Chapter 119, Florida Statutes, and is open to public inspection.
2. I am responsible for keeping the information on this form current and provide any changes or updates to the Office of the City Clerk.
3. I consent to filing a Statement of Financial Interests (Form 1) required if required for the board in which I am appointed to.
4. If appointed to a board/committee, I acknowledge that this is my obligation and duty to comply with the following:
Code of Ethics for Public Offices (Florida Statutes, Chapter 112, Part III) Florida Sunshine Law (Florida Statutes, Chapter 286)
By typing in my full name above, I am acknowledging that the above information is accurate and I understand all of the information provided to me on this application and that I consent to all of the above.
This field is not part of the form submission.
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