Application for Appointment

Application for appointment to:

Name:

Address:

City or Town:

Zip or Postal Code:

Phone:

Business Address:

City or Town:

Zip or Postal Code:

Are you a resident of Calhoun County   Yes No
Length of residence in Calhoun County

Education

Relevant Organizations/Affiliations

Relevant Employment/Volunteer Experience

Work Phone

Military Service (for Veteran's Affairs Committee Applicants)

Brief Statement as to interest in serving on this Board/Commission

Have you been convicted of a felony within the past 10 years?    Yes  No
If yes, please explain (You do not need to disclose a felony that has been legally expunged.)

Are there any felony charges pending against you?   Yes   No
If yes, please explain. (Answering yes to either question does not necessarily disqualify an applicant.)

References (Name, Address, Phone)
Reference #1

Reference #2

Reference #3

Note: You may be required to be a resident of Calhoun County to serve on certain boards and committees.
Email Address
 
Are you employed in Calhoun County   Yes   No

Upload resume or Curriculum vitae in one of the following formats: Word(.doc,.docx), PDF(.pdf), Plain Text(.txt):