Grand Traverse County Boards and Commissions appointment application.

Email:	ccramer@grandtraverse.org
FAX:	231-922-4636
Mail:	Grand Traverse County Board of Commissioners 400 Boardman Ave Traverse City, MI  49684

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Applicant Name and Address Information First Name Middle Initial Last Name Home Address City Zip Email Address Please enter phone numbers with area code in order of preference: Phone Number 1 Phone Number 2 Phone Number 3 Board/Commission Interests Please choose the board(s)/commission(s) for which you would like to be considered (in order of preference). Choice 1 Aging, Commission onAirport CommissionBATA BoardBrownfield Redevelopment AuthorityCommunity Corrections Advisory BoardEconomic Development CorporationNorthern Lakes Community Mental Health BoardParks and Recreation CommissionPlanning CommissionPublic Works, Board ofResource Recovery CouncilRoad CommissionTraverse Area District Library BoardVeterans Affairs Administrative CommitteeOther (Please see below) Choice 2 Aging, Commission onAirport CommissionBATA BoardBrownfield Redevelopment AuthorityCommunity Corrections Advisory BoardEconomic Development CorporationNorthern Lakes Community Mental Health BoardParks and Recreation CommissionPlanning CommissionPublic Works, Board ofResource Recovery CouncilRoad CommissionTraverse Area District Library BoardVeterans Affairs Administrative Committee Appointments are also made to the following Boards and Committees although the frequency of meetings and/or membership is limited and consequently, so is the turnover. Application is welcomed and we will contact you if there is an opening. Appeals Board - Building Soil Erosion, Health and BOCA Building Authority Central Dispatch Policy Board Farmland Preservation Gun Board Hospital Finance Authority Human Services Board (formerly FIA) Inspections Appeals Board Northern Michigan Substance Abuse Council Workforce Development Board Additional choices and/or other Boards/Commissions that may not be listed above. Is this an application for reappointment? NoYes Brief statement regarding your interest in service on the board/commission. Employment and Related Experience Employment and Related Experience (If answered in full on your resume, please indicate): Employer name and address: Position title or nature of work What special skills could you bring to this position? EDUCATION (Include degree and dates; if answered in full on your resume, please indicate) Previous government appointments Do you hold any professional licenses required for the committee on which you're interested in serving? If so, please include number or other pertinent information. Have you ever been convicted of a misdemeanor offense? NoYes Have you ever been convicted of a felony offense? NoYes Veteran's Affairs committee applicants only. Enter military service with years and conflict (i.e. Vietnam, Desert Storm) Commission on Aging applicants only. Enter year of birth. I hereby certify that the information contained in this application is true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand than any misrepresentation, falsification or omission of information on this application or on any document used to secure appointment shall be grounds for rejection of this application or immediate discharge if I am appointed, regardless of the time elapsed before discovery. I further understand that all applicants selected to serve, are subject to background check including criminal history, drivers record, and Michigan Sex Offender Registry. I also understand that a background check will be run on all applications including criminal history, drivers record, and Michigan Sex Offender registry. I further understand that this application and all related information are public records subject to disclosure pursuant to the Michigan Freedom of Information Act. I agree with and consent to all of the above.