HomeMy WebLinkAboutVolunteer ApplicationName:
Mailing Address:
City:
Email:
Employer:
I am applying to serve on:
Please provide a brief background sketch including education, job experience, skills, hobbies and special areas of interest:
Organizations/Affiliations:
What community activities have you participated in during the past five years?
Are you serving, or have you served on any citizen advisory boards, commissions, committees or task forces? If yes, please list board/committee names and dates served:
Why are you applying for this appointment?
What problems, issues or concerns do you see facing this particular Task Force, and how would you propose they be addressed?
What special skills, knowledge, or experience do you have to contribute to this Task Force?
It is desirable 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:
What limitations, if any, are there on the time you would be available for meetings and other activities? How much time are you able to devote to the duties of this Task Force?
Additional information you would like to provide about yourself:
I understand that this appointment will entail my attendance at meetings and participation in activities of this Task Force. All of the information on this application is true to the
best of my knowledge.
Date
Please return to:
Board or Commission
Jefferson County Administrator's Office
PO Box 1220
1820 Jefferson Street
Port Townsend, WA 98368
Signature of Applicant
State:
Zip:
Occupation:
I reside in Commissioner District Number:
Date:
Home Phone:
Work Phone:
Cell Phone:
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