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Board and Commissions Application Form

  1. Education
  2. Civic Activities
  3. References
  4. Persons who are not relatives. List name, address and phone number(s).
  5. Criminal Record and Child Protective Service Information
  6. (Provide information regarding the nature of the convictions and approximate date(s) of "Yes" answers.)
  7. BY CLICKING "SUBMIT" YOU ARE SENDING AN ELECTRONIC SIGNATURE THAT VERIFIES EVERYTHING IN THIS APPLICATION IS TRUE AND ACCURATE. IF YOU DO NOT WISH TO SUBMIT AN ELECTORNIC SIGNATURE, PLEASE USE THE CANCEL BUTTON TO EXIT THE APPLICATION.
  8. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  10. This field is not part of the form submission.