APPLICATION FOR APPOINTMENT TO COMMITTEES, BOARDS AND COMMISSIONS

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To which committee, board or commission are you seeking appointment? Fill out one form for each committee/board/commission.
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Community Service
List boards, commissions, committees or community service organizations that you are currently serving or have served upon, offices held and in what municipality or county
List any employment experience or education that, in your opinion, best qualifies you for this appointment. List job titles, duties (current and past), level of education and any certificates or degrees you have obtained
If yes, please list dates and name(s) of departments
Personal
Rules of law and ethics prohibit appointees from participating in and voting on matters in which they may have a direct or indirect financial interest.
If yes, please indicate potential conflicts
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Please provide information about specific training, education, experience or interests you possess that qualify you as an appointee to the position you seek
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*Enter the letters you see