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gadsden county

Citizen Advisory Committee Application

If you have a desire to serve your community by volunteering with a BOCC Citizen Advisory Committee, please complete the on-line application below. Once your application is submitted, you will receive an email confirmation. If you should require assistance, please contact the County Administrator's Office at 850-875-8650.

* Denotes a required field

Date* 

APPLICANT
First Name*

Last Name*

Occupation*

Employer


PHYSICAL ADDRESS
Address*

City*

State*

ZIP*

Second portion of ZIP Code is optional.


MAILING ADDRESS
Address *

City*

State*

ZIP*

Second portion of ZIP Code is optional.



CONTACT INFORMATION
Home Phone

Work Phone

Mobile Phone

Email


APPLICATION DATA
Do you live in Gadsden County?*

Do you own property in Gadsden County?*

Do you CURRENTLY serve on a County Advisory Committee?*

If you currently serve on a County Advisory Committee, please list the name of that/those committee(s):

Have you PREVIOUSLY served on a County Advisory Committee?*

If you have previously served on a County Advisory Committee, please list the name of that/those committee(s) along with the beginning and ending dates of service:

Are you interested in serving on any specific committee? If so, please indicate your 1st and 2nd choice below.
1st Choice

2nd Choice


MEETING ATTENDANCE
If you're appointed to a committee, you're expected to attend regular meetings. Are you available to attend meetings at least once a month?
 Yes  No
What times are you available to attend meetings?*
 Mornings  Afternoons  Evenings


EXPERIENCE (If you wish to submit your professional resume, you may do so via email to Laurel Bradley at lbradley@gadsdencountyfl.gov.)

Please describe or list any previous experience you have serving on committees.

Please list your educational background.

Please list your skills and experience that enable you to contribute to the committee(s) you are interested in volunteering with.

Professional licenses and/or designations, their effective date and whether said licenses are effective in Gadsden County:

Please list any charitable or community activities in which you participate.

REFERENCES (you must provide at least one personal reference who IS NOT a family member)
Reference #1's relationship to you:*

First Name*

Last Name*

Contact #*

Address*

City*

State*

ZIP*

Second portion of ZIP Code is optional.

Reference #2's relationship to you:*

First Name*

Last Name*

Contact #*

Address*

City*

State*

ZIP*

Second portion of ZIP Code is optional.