HomeMy WebLinkAboutThomas - Volunteer ApplicationName:
AUG 0 4 2014
Mailing Address: At-
Date:
Home
Work Ph:
I am applying to serve on: �L f I reside in Commissioner District Number:
Board or Commission
Educational Background:
Experience:
Organizations /Affiliations:
Community Interests:
Have you served on any other Jefferson County Board, Commission, Committee, Council or Task Force? If yes,
please list: /O
BOARDS and COMMISSIONS VOLUNTEER APPLICATION /STATEMENT OF INTEREST
Why are you applying for this appointment?
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List your qualifications for this appointment (include skills, activities, training, etc.): _j_ Shy
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It is desireable for Advisory Board and Commission members to have a broad collective knowledge and interest
in various ethnic, religious, cultural, educational and community views. Describe your strengths in this area:
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Additional information you would like to provide about yourself:
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I understand the member responsibilities, and am aware that this appointment will entail my attendance at meetings and
participation in activities of this Board /Commission. All of the information on this application is true to the best of my
knowledge.
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ignature of A
Please return to: Jefferson County Commissioners, P.O. Box 1220 / 1820 Jefferson Street, Port Townsend, WA 98368