WRWSD Board of Trustees Application for Candidacy (for Mid-Term Vacancy)
This application is to fill a vacancy on the Waynoka Regional Water and Sewer District Board of Trustees for a 2025 - 2027 term to end at the Annual Meeting in 2028. The candidate will be selected by the Board of Trustees per WRWSD Procedural Rules and Regulations Article II, Section 2.5.
The undersigned herewith files an application as a candidate for election to the Board of Trustees of the Waynoka Regional Water and Sewer District. By signing, I herewith certify that all information contained in this application and all attachments are true and correct to the best of my knowledge and belief.
1. All WRWSD DUES, ASSESSMENTS, FEES or other charges, if any, are paid in full as they have been currently invoiced.
2. A recent photograph will be emailed to election@lakewaynoka.com after this form has been submitted. A good quality, passport type photo is preferred.

INSTRUCTIONS: (Any deviations will result in application being rejected.)
• Application must be on this form.
• Application must be signed by the applicant. Typing your name into the form is your signature.
• Application must be submitted by October 24th, 2025, 4 PM. No exceptions to this deadline will be allowed.  
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Email *
Date *
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DD
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YYYY
Please type your name to sign this form. Your typed name will serve as your signature. *
Lot # *
Address *
City, State, Zip *
Phone *
In 150 words or less, introduce yourself with a short statement of your work experience and educational background.  Also explain why you are applying for a Trustee position, how you can be of benefit to the Board and why you should be considered. *
A copy of your responses will be emailed to the address you provided.
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