Form Center

2. Citizen Advisory Committee

   The purpose and mission of the citizen advisory committee will be to bring any concerns in our community to our attention. We would like to enhance our communication and ask committee members for feedback. The best public programs and ideas usually emerge from the collaborative efforts of the community and Law Enforcement together. We are seeking a culturally diverse representation of our community. Each volunteer must genuinely represent our community and be able to meet quarterly or more often as needed. Sheriff Montgomery encourages citizens to be engaged and feels that the implementation of a citizen advisory committee can be vital to maintaining public trust and displaying transparency.

4. Do you own a business or live in York County or Poquoson? *

   1. Yes

   1. No
5. How long have you owned a business or lived in York County or Poquoson?*
7. Are you a United States Citizen?*

   1. Yes

   1. No
9. First Name, Middle Initial, Last Name:*
10. Mr., Mrs., Miss, Rank*
12. Address:*
14. City:*
15. State:*
16. Zip code:*
18. Email Address
20. Primary Phone Number:*
21. Alternate Phone Number:
23. Profession / Occupation:*
24. Current Employer:*
26. Please share any of your interests and/or experience which you would like us to consider.
28. Please share your volunteer experience and/or special skills.
30. It is our intention to reflect diversity in the composition of this committee. For this reason, we request certain demographic information from applicants.
31. Age: *
    -- Select One --Born before 1945Born between 1946 – 1964Born between 1965 – 1982Born between 1983 – 1998Under 18 years of age
33. Criminal Background Statement*

    1. I Agree

    1. I Do Not Agree

    Please note due to the sensitive nature of some of the information concerning tactics and officer safety, individuals will have to successfully complete a criminal background check prior to appointment.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field