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Board and Commission Application

Title

*First Name

*Last Name

*Address

*City

*State

*Zip

*Email

Phone

Cell Phone

Board or Commission you would like to serve on.

*Board

Political Party
Please provide a brief explanation of why you would like to serve on this board or commission.

*Comment

Please provide a brief resume including educational and work experience.

*Resume

List all current organizations and societies of which you are a member.

*Current Organizations and Societies

*Are required fields.
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