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2. 

4. BOARD/COMMISSION APPLICATION

   County Executive and County Council members will review the following information for your possible appointment to a board or commission. 

   Please note, this data will become public information.

6. Board or Commission Preference(s):*

   *Term runs concurrent with County Executive’s Administration

   1. Adult Public Guardianship Review Board
   2. Advisory Board on Aging
   3. Agricultural Land Preservation Advisory Board
   4. Board of Electrical Examiners*
   5. Board of Estimates*
   6. Board of Ethics
   7. Building Code Board of Appeals
   8. Citizens Care & Rehabilitation Board
   9. Commission on Disabilities
   10. Commission on Veterans’ Affairs*
   11. Commission for Women
   12. Community Advisory Board
   13. Criminal Justice Coordinating Council*
   14. Cultural Arts Advisory Board*
   15. Deer Creek Scenic River Advisory Board
   16. Department of Social Services Advisory Board
   17. Economic Development Advisory Board*
   18. Economic Development Agricultural Advisory Board*
   19. Environmental Advisory Board*
   20. Harford Center Board of Directors

   1. Harford County Community Mediation Commission*
   2. Harford Soil Conservation Board of Supervisors*
   3. Healthy Community Planning Board
   4. Historic Preservation Commission
   5. Human Relations Commission*
   6. HVAC Board*
   7. Liquor Control Board
   8. Local Management Board *
   9. Mental Health & Addictions Advisory Council
   10. Parks & Recreation Advisory Board*
   11. Personnel Advisory Board*
   12. Planning Advisory Board*
   13. Plumbing Board*
   14. Property Tax Assessment Appeal Board
   15. Public Library Board of Trustees
   16. Public Works Advisory Board*
   17. Spending Affordability Advisory Committee*
   18. Towing Appeals Board*
   19. Youth Commission*
8. Are you a registered voter?*

   1. Yes
   2. No
9. What is your political affiliation?*

   1. Democrat
   2. Republican
   3. Unaffiliated

   (Some county boards and commissions require a balance of political-party representation)

13. First Name:*
14. Last Name:*
16. Address:*
18. City:*
19. State:*
20. Zip Code:*
22. Phone:*
23. Email:*
25. Occupation/Employer:*
26. Race:*
28. Education/Background:*
29. Affiliations:*

    (Civic/Organizations)

31. Please submit a concise statement of interest in serving and describe relevant experience and any additional qualifications not covered by the application:*
33. To the best of my knowledge, the above information is correct and may be used by the County Executive and the County Council in considering my nomination to a board or commission.
35. Signature:*

    (Please type your name here)

36. Date:*
    Date:

38. This document is available in alternative format upon request.

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field