Boards, Authorities & Commissions Application

Application to serve on a specified Board, Authority or Commission for appointment by the Board of Commissioners.

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Board, Authority or Commission on which you would like to serve *

Why do you want to serve on this Board, Authority or Commission?

Name *

Residence Address *

Home Phone

Cell Phone

Email Address

Mailing Address (if different from above)

Are you registered to vote in Banks County? *

Yes

Occupation

What appointed, elected or paid positions do you hold or have you held with Banks County Government?

Include dates.

What would be your biggest contribution if appointed to this position?

Other comments or information:

FINAL STEP: As the final step you will be required to enter a digital signature which will be binding as your actual signature. Your electronic signature below indicates your agreement with the following statements: I have been informed and understand the obligation and commitment required by this position. By typing my name in the following box I certify the above statements to be true and correct to the best of my knowledge, and that this information can be used for the purpose of processing my application and information. *

Date

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Boards, Authorities & Commissions Application

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