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Advisory Board/Committee Application Form

2. Depending on the specific committee, a separate application may be requested.

4. Select the Board of Committee you are applying for:*
   -- Select One --Affordable Housing Advisory CommitteeAviation Advisory CommitteeBagdad Architectural Advisory BoardBuilding Board of AdjustmentCitizen's Advisory Task ForceCivil Service BoardLibrary Advisory CommitteeLocal Mitigation Strategy Task ForceLocal Option Sales Tax Oversight CommitteeLocal RESTORE CouncilMarine Advisory CommitteeParks and Recreation CommitteeTourist Development CouncilZoning BoardInterested in serving on any committee

6. First Name*

7. Last Name*

9. Home Address*

11. City*

12. Zip Code*

14. Phone Number*

15. Email Address*

17. Occupation:*

18. Have you ever been convicted of a felony?*

    1. Yes
    2. No

20. Length of Residency in Santa Rosa County:*

    Enter the number of years you have lived in Santa Rosa County.

21. Are you a registered voter:

    1. Yes
    2. No

25. High School

26. College

28. Trade or Business School

32. Are you currently serving on a Board or Committee within Santa Rosa County?*

    1. Yes
    2. No

33. If yes, which:

35. Have you served on a Board or Committee before?*

    1. Yes
    2. No

36. If yes, which:

38. List all county and city Boards, Commissions, or Committees (Santa Rosa County or elsewhere) on which you have previously served (include dates of service):

40. Please provide a brief explanation of why you want to serve:

42. Please list any special qualifications you may have:

44. Type of Resume
    -- Select One --Basic resume (text only)Upload resume (word document preferred)

46. Please enter basic resume information or upload a resume:

48. Upload Resume

Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field