Response

Boards and Commissions Membership Expression of Interest

Use this form to express interest in serving on a gubernatorially appointed board or commission.

Contact Information

Prefix

First Name

Last Name

Suffix

Title

Organization

Address Line 1

Address Line 2

City

State

Zip

Phone

Confirm Email

Cell Phone

Work Phone

Which board or commission are you interested in serving on?

Reason you are interested on serving on the board?

Are you a family member of an elected official? Yes
No

Are you currently serving on any other board or commission? Yes
No

If yes, please list the name of the board or commission on which you currently serve.

Resume Please attach a current version of your resume in Word or PDF format. Please ensure that the file size is 8MB or smaller.

Upload FileNo file chosen

What is your gender? Female
Male
Prefer not to say

If you selected "Prefer to self-describe" in the question above, please fill in here.