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Agenda - 01-31-2012 - 4
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Agenda - 01-31-2012 - 4
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8/3/2012 10:01:43 AM
Creation date
1/27/2012 12:33:59 PM
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BOCC
Date
1/31/2012
Meeting Type
Work Session
Document Type
Agenda
Agenda Item
4
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Minutes 01-31-2012
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\Board of County Commissioners\Minutes - Approved\2010's\2012
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Board Application <br />Page 1 of 2 <br />21 <br />Mecklenburo County > BOCC > Advisors Boards > Board Application <br />Mecklenburg County Advisory Board Application <br />The Mecklenburg County Board of Commissioners appreciates the interest of all citizens willing to <br />serve their Community through participation on County advisory boards. For a hard copy of the <br />' application form, call the Clerk's office, or send an E-mail. You can also submit the application <br />online thanks to Mecklenburg County e-Government: <br />(one board per application) <br />Name of Advisory Board: <br />Name: _ <br />', (Please do not use P.O. Box numbers.) <br />Home address: _ _ __ _ __ <br />City <br />' Zip code: <br />Home Phone: <br />Work Phone: <br />E-Mail: <br />Occupation: <br />', Place of employment: _ _ _ _ <br />Race: <br />Sex: <br />_' Female <br />._.' Male <br />Age: <br />j Hours per month available <br />' for position: -- --- <br />County advisory board <br />currently serving on: <br />._ ......................................_.... <br />Expiration date: <br />Education: <br />Business and civic <br />experience: <br />_ __ _. _ . <br />Areas of expertise and <br />interests/skills: <br />Below are boards requiring representation of certain professions or sectors of the <br />community. Please check where applicable. Thank you for your interest in serving your <br />community. <br />Board of Equalization and Review <br />!J! Attorney <br />' ~~ CPA <br />_Commercial Real Estate Representative <br />' ~_.~ Residential Real Estate Representative <br />Adult Care/Nursing Home Committies <br />Your response will determine which you are eligible for. If none apply, you're eligible for both. <br />: ...i Do you or an immediate family member have a financial interest in a home served by the committee? <br />Are you an employee or a board member of a home served by the committee? <br />IIS an immediate family member a resident in an Adult Care or Nursing Home? <br />Building Development Commission <br />http://charmeck.org/mecklenburg/countyB OCC/AdvisoryBoards/PagesBoardApplication.... 12/9/2011 <br />
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