Boards and Commissions Application Form

Agency on Aging, Peninsula

Disability Services Board, Peninsula

Regional Issues Committee

Alcohol Safety Action Program, Virginia Peninsula

Economic Development Authority

Senior Center Board

Arts Commission, York County

Employee Grievance Panel

Social Services Board, York-Poquoson

Beautification Committee

Equalization, Board of

Stormwater Advisory Committee, Citizens

Bicycle Committee, Regional

Historical Committee

Thomas Nelson Community College Board

Building Code Appeals, Board of

Historic Yorktown Design Committee

Transportation Safety Commission

Colonial Group Home Commission

Library Board

Wetlands Board

Colonial Services Board

Parks and Recreation Advisory

Zoning/Subdivision Appeals , Board of

Community Correction Justice Board

Planning Commission

I would like to be considered for the following board(s)/commission(s): (Choose a maximum of three from the list above - in order of preference)

Other Interests:

Education:

Job Experience:

Civic or Service Organization Experience:

Are you currently a member of a York County board or commission?

Yes

If Yes, please name:

Have you previously served as a member of a York County board or commission?

Yes

If yes, please name:

Are you a registered voter?

Yes

Voter District Number:

Enter the lower case letters you see in the box above:

Thank you for your application and your willingness to serve the citizens of York County.