Carteret County North Carolina

Application for 2009 Boards & Commissions Appointment
(Please note all fields are required, except those denoted by an *)

Name

E-Mail

Address

City/State

Zip

Telephone: (xxx) xxx-xxxx or xxx-xxx-xxxx

Home

Work

Cell

Fax

Occupation

Employer

Please describe your background, experience, education or training (work and/or life experience) that relates to your interest in county government:

Select the committees of interest:

Primary Interest:

* Secondary Interest:


* Unlisted Board/Commission selected as a primary or secondary interest above:


Are you currently serving in one or more appointed or elected positions in any Federal, State or Local Government Agency?		Yes
		No

If so, please give the following information:

Position:
Organization:
Dates:

Please explain any anticipated conflict of interest or scheduling difficulties you may have, if appointed:

Number of years living in Carteret County:

Are you a registered voter in Carteret County:

Yes

This application will be retained on file for eighteen (18) months from the date of receipt.

(When vacancies on various Boards occur, your application will be
considered along with the other received. You may submit a resume
in addition to this application, if you so desire. Also, note that this document is considered a public document.)

Enter the code exactly as you see it in the image:-
(Cookies must be enabled)

Code Image - Please contact webmaster if you have problems seeing this image code

Load New Code