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Board / Commission Member Application

2. First Name*

3. Last Name*

5. Address1*

7. Address2

9. City*

10. State*

11. Zip*

13. Email*

14. Phone Number*

16. Board or Commission*
    -- Select One --Audit CommitteeBoard of AdjustmentBoard of Assessment ReviewBoard of License, Inspection & ReviewCommunity Services BoardDiversity CommissionDRAC of CentrevilleDRAC of HockessinDRAC of St. GeorgesEthics CommissionFinancial Advisory CouncilFire & Ambulance Advisory BoardHistoric Review BoardHousing Advisory BoardHuman Resources Advisory BoardLibrary Advisory BoardOther Post Employment Benefits Board of TrusteesPension BoardPlanning BoardPlumbing & Mechanical Technical Advisory BoardRental Housing Advisory CommitteeResource Protection Area Technical Advisory Committee

    Please select the board or commission on which you are interested in serving.

18. Brief Statement of Interest*

    Please briefly state why you would like to join the board or committee.

20. Resume*

Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field