2. County of Cape May
   Application for Appointment to Citizen Advisory Boards and Commissions

   Please read and complete all sections of this application.

4. First Name
5. Last Name
7. Home Address
9. City
10. State
11. ZIP
13. Home Phone
14. Cell Phone
16. Email Address
18. Do you reside full time in Cape May County?

    1. Yes

    1. No
20. Are you 18 or older?

    1. Yes

    1. No
22. Are you a US Citizen?

    1. Yes

    1. No

26. Statement of Interest

    For which Board or Commission would you like to be considered?

28. 1st Choice
30. 2nd Choice
32. 3rd Choice

34. Experience and Education - Please attach your resume with references.

38. Civic Activities (Including, but not limited to other boards/commissions)
40. Education/Experience
42. Please write a brief statement of 75 words or less, explaining your interest in the board or commission for which you are applying. Include any training and/or qualifications for this position. Also indicate any conflicts of interest which may arise if you are chosen for a board or commission.
46. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
48. Electronic Signature
49. Date
    Date
51. Please attach your resume with references.
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field