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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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