3. 
6. Applicants must complete this application form in order to be considered for appointment to boards and commissions.
8. Select one*

   1. New Appointment
   2. Reappointment
10. First Name*
11. Last Name*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Home/Cell phone:*
    xxx-xxx-xxxx
20. Work Phone
    xxx-xxx-xxxx
21. E-mail*
23. Registered Voter in Frederick County?*

    1. Yes
    2. No
25. Please indicate the name of the boards/commissions you are interested in serving (please list no more than three (3) and rank them in order of preference):*
27. Explain why you are interested in serving:*
29. Do you presently serve on a public board or commission?*

    1. Yes
    2. No
31. If yes, please list those with which you are involved and state whether it is a local, regional, state, or federal group.
33. Is there anything else about yourself that you would like to state on this application? If so, please describe:
35. Please attach a resume that includes work experience, education, affiliations (civic/organizations) and any special interest.
    PDF or Word Format
37. To the best of my knowledge the information contained herein is correct and may be used by Frederick County Government in considering my appointment to a board or commission.
39. Applicant Signature (print name)*
40. Date:*
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field