Boards and Commissions Application

Please complete the application below. If you have any questions contact [email protected].

Application:

A current application and resume are required both for initial appointment or reappointment consideration.

Resume Required:

You may submit your resume in PDF format using the form below.

Instructions for Letters of Recommendations:

The Governor’s Office welcomes and needs written assessments of the applicants' skills, expertise, ethics and any other characteristic relevant to an individual's potential for an appointment. Many applicants solicit letters of reference supporting their efforts at an appointment. However, applicants are advised "more" is not necessarily "better." The Governor’s Office would prefer to receive no more than 10 substantive e-mails regarding each applicant. The preferred means of communicating recommendations to the Governor’s Office is through e-mail. Please direct any such e-mails to [email protected].

Contact Information

Title

First Name *

Middle Initial

Last Name *

Spouse Title

Spouse First Name

Middle Initial

Spouse Last Name

Residential Address *

City *

State *

Zip *

County

Mailing Address *

City *

State *

Zip *

Primary Phone Number *

Secondary Phone Number

Email *

Employment Information

Business Name

Your Work Title

Office Address *

City *

State *

Zip *

Work Phone *

Preferred Delivery Method for Mail *

Mailing Address

Office Address

Board/Commission Interest

Please select a board/commission of interest.

Board/Commission *

Board/Commission 2

Board/Commission 3

Personal Information

Date of Birth *

Place of Birth

Ethnicity

Party Registration *

Referred By

Background Investigation

I understand a background investigation may be conducted as part of the application process. *

I Understand

Note: a Driver's License or State ID is required to complete a background investigation.

Drivers License State *

Drivers License # *

State ID # *

A BACKGROUND INVESTIGATION WILL BE REQUIRED TO COMPLETE YOUR APPLICATION

Professional Experience

Education *

Please include education including any degrees completed.

References *

List THREE references. Include the NAME and PHONE of the Business/Company/Agency.

Resume *

Attach your resume in PDF format.
Files must be less than 2 MB.
Allowed file types: pdf.

Authenticity of Information

I certify that the facts contained in this application are true and correct to the best of my knowledge. I have reviewed the statutory requirements governing the board/commissions in which I have expressed an interest and confirm that I meet those requirements. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my qualifications and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damages that may result from furnishing the same to you. Entering my name and the date below has the same legal ramifications as a hand signed document.

Digital Signature *

To sign, type your name

Date of Application *

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