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Board Application Page 1 of 2 21 Mecklenburo County > BOCC > Advisors Boards > Board Application Mecklenburg County Advisory Board Application The Mecklenburg County Board of Commissioners appreciates the interest of all citizens willing to serve their Community through participation on County advisory boards. For a hard copy of the ' application form, call the Clerk's office, or send an E-mail. You can also submit the application online thanks to Mecklenburg County e-Government: (one board per application) Name of Advisory Board: Name: _ ', (Please do not use P.O. Box numbers.) Home address: _ _ __ _ __ City ' Zip code: Home Phone: Work Phone: E-Mail: Occupation: ', Place of employment: _ _ _ _ Race: Sex: _' Female ._.' Male Age: j Hours per month available ' for position: -- --- County advisory board currently serving on: ._ ......................................_.... Expiration date: Education: Business and civic experience: _ __ _. _ . Areas of expertise and interests/skills: Below are boards requiring representation of certain professions or sectors of the community. Please check where applicable. Thank you for your interest in serving your community. Board of Equalization and Review !J! Attorney ' ~~ CPA _Commercial Real Estate Representative ' ~_.~ Residential Real Estate Representative Adult Care/Nursing Home Committies Your response will determine which you are eligible for. If none apply, you're eligible for both. : ...i Do you or an immediate family member have a financial interest in a home served by the committee? Are you an employee or a board member of a home served by the committee? IIS an immediate family member a resident in an Adult Care or Nursing Home? Building Development Commission http://charmeck.org/mecklenburg/countyB OCC/AdvisoryBoards/PagesBoardApplication.... 12/9/2011