Please complete the following application to serve on an advisory board or commission. If you have questions or comments, call us at 503-655-8751 or email us at citizeninvolvement@clackamas.us. I have read and agree to the Clackamas County Advisory Board and Committee Volunteer Code of Conduct * First Name * Middle Initial * Last Name Under 25 years of age Over 25 years of age * Home Mailing Address * City * State ALAKARASAZCACOCTDCDEFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNBNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAWAWVWIWY * Zip * Home Phone Unincorporated Incorporated Employer Address City State ALAKARASAZCACOCTDCDEFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNBNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAWAWVWIWY Zip Title Occupation Business Phone Cell Phone Email * What Board or Commission Interests you? Committee For Community Involvement Community Health Council Community Road Fund Advisory Committee (CRFAC) NCPRD-Milwaukie Community Center Community Advisory Board If the board or commission to which you are applying requires a specific experience area, describe the experience area for which you are most qualified (architect, doctor, general citizen, etc.). What are your community Interests (committees, organizations, activities)? What experience or educational background might be significant to this Board or Commission? What are the reasons for your Interest in this Board or Commission? List other County Boards or Commissions on which you serve or have served. Referred by (if any)
