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Citizen Profile for Appointment Application
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Name:
*
Address:
*
Phone:
*
E-mail:
*
Name of Spouse:
*
Registered Voter:
*
Yes
No
I would be interested in serving on the following boards or committees:
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Airport Commission
Alcohol Control Commission
Board of Appeals & Adjustments
Board of Elections & Registration
Development Authority of Floyd County
Floyd County Board of Family & Children's Services
Floyd County Board of Health
Floyd County Board of Assessors
Floyd County Library Board & Sara Hightower Regional Library Board
Floyd County Merit Board
Georgia Department of Behavioral Health & Developmental Disabilities Board
Gordon-Floyd Development Authority
Highland Rivers Community Service Board
Northwest Georgia Region I Emergency Medical Services Coordinating Council
Northwest Georgia Regional Commission
Rome-Floyd Citizens Advisory Committee
Rome-Floyd Land Bank Authority
Rome-Floyd Parks and Recreation Authority
Rome-Floyd Planning Commission
Tallatoona Community Action Partnership
Place of Employment:
*
Title:
*
Education (select one):
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High School
Two-Year Degree
Four-Year Degree
Post Graduate Degree
Previous Community Involvement:
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Are you at least 18 years of age?
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Yes
No
Are you a resident of Floyd County?
*
Yes
No
Have you ever been convicted of a felony?
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Yes
No
Do you owe any delinquent tax to Floyd County?
*
Yes
No
Are you willing to attend training relative to the responsibilities of the Board Membership, as provided by Floyd County?
*
Yes
No
Educational Background:
*
Select all that apply.
High School
Technical School
College
Graduate School
High School Name, Location, Level Completed:
*
Technical School Name, Location, Degree Earned:
*
College Name, Location, Degree Earned:
*
Graduate School, Location, Degree Earned:
*
Please summarize any prior experience you possess which would be applicable to the appointment you are requesting:
*
Please summarize why you wish to serve in the appointment you are requesting:
*
Boards and Committees
Agendas/Minutes
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Boards and Committees Home
Administrative Services Committee
Airport Commission
Board of Adjustments
Board of Assessors
Board of Elections & Registration
Development Authority of Floyd County
Elected Officials Committee
Floyd County DFCS Board
Joint Services Committee
Merit Board
Parks and Recreation Advisory Board
Public Safety Committee
Public Utilities & Transportation Committee
Rome-Floyd Citizens Advisory Committee
Rome-Floyd Development Authority
Rome-Floyd SPLOST
Contact Information
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