Boards & Commissions Application

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Application Date *

Prefix *

Name *

First

Middle

Last

Address *

Address Line 1

City

State

Zip Code

Phone

Email *

About yourself

EDUCATION

School or University

Number of Years Attended

Subjects Studied

Employment and Other Positions Held

Current Employer

Current Position

Employed From

Employed To

Licenses Held/ Skills *

Boards / Committees that you serve on, or have served on

(business, civic, community, fraternal, political, professional, recreational, religious, and social)

Organization / Committee

Name

Position Held

From

Board / Committee Selection

Please indicate your interest in no more than ONE committee. A separate form must be filled out for each board application. Click the button below to submit this application:

Applying for Board / Committee: *

Are you willing and able to attend board meetings? (which may be day or evening) *

Why are you interested in applying for this board? *

What is your background as it relates to this board application? *

What do you hope to accomplish on this board? *

Are you a resident of Washington County, MD? *

Does your schedule allow you to commit to a three-year term? *

Resume Upload *

Click or drag a file to this area to upload.

Additional Comments

County Clerk

100 West Washington Street
Hagerstown, MD 21740
Room 1101

Telephone: 240-313-2204
FAX: 240-313-2201

The office is open from 7:30 a.m. to 4:30 p.m. Monday – Friday

TTY users may call any government office through the Maryland Relay Service 1-800-735-2258

Boards & Commissions Application

About yourself

Employment and Other Positions Held

Boards / Committees that you serve on, or have served on

Board / Committee Selection

County Clerk

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