Application for Service on Washington County Boards and Commissions
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Personal Information Please fill in the blanks.
Name: Street Address: City: Zip Code: Home Phone: Business Phone (if applicable): Email Address:
School/Experience: Degree/Position: Major/Minor Field of Study:
Job Title: Organization/Firm: Beginning Date: Ending Date: City/State:
Organization: Special Projects/Positions Held: Dates of Membership:
Board/Commission:
Local Regional State Federal
Not Interested Very Interested 1 2 3 4 5 Agricultural Education Center Ag Marketing Agricultural Land Preservation Advisory Board Airport Advisory Commission Adult Public Guardianship Review Board Animal Control Authority Black Rock Golf Course Commission on Aging Disability Advisory Commission Electrical Board Emergency Services Advisory Board Economic Development Ethics Commission Fire & Rescue Communications Advisory Committee Gaming Commission Historic District Commission Housing Authority Local Management Board Mental Health Authority Pen Mar Development Corp. Planning Commission Plumbing Board Recreation & Parks Board Solid Waste Advisory Committee Social Services Board Water uality Advisory Commission Women's Commission Zoning Appeals
Other Areas of Interest?
Thank you for your willingness to make a difference in Washington County by offering your time and service. Your application will be kept on file for the next three years with the Board of County Commissioners and will be consulted when appropriate board vacancies arise.
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Document Modified: 10/19/09 2:28 PM
