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2. Name of Committee, Commission or Board*

   Type the complete name of the committee, commission or board that you are applying/reapplying to. Avoid acronyms if at all possible.

4. Applicant Type*

   Choose one

   1. New Applicant
   2. Application for Reappointment
5. How long have you lived in Lincoln County?*
7. Name*
8. Email Address
10. Address*
12. City*
13. State*
14. Zip Code*
16. Cell Phone
17. Home Phone
19. Occupation
20. Work Phone
22. Business Address
24. City
25. State
26. Zip Code
28. 1. Experience/Training*

    Please give a brief description of your experience, training, special interest or involvement in the community that supports your nomination to this committee.  If you wish, you may attach a resume or other materials.

30. File Upload

    Please upload documents here. .pdf, .jpeg, .png are accepted file types.

32. 2. Concerns*

    Please list the concerns you would like to address if you are appointed to this committee.

34. The Board of Commissioners encourages citizen involvement and appreciates your interest. If you are not selected for this particular committee, and you are interested in serving on another committee for Lincoln County, or want to know what committees are currently active, please contact the Board of Commissioners Public Information Officer boc@co.lincoln.or.us or call (541) 265-4100

    Lincoln County does not discriminate against any person on the basis of race, color, sex, religion, political affiliation, national origin, handicap, or age in employment or in admission, treatment or pa1ticipation in its programs, services and activities. 

    The appointment process may be lengthy -- you will be notified of the Board's decision.

    Selected applicants will be subject to the county's background check process for volunteers.

    
    

36. 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.
38. Electronic Signature
39. Date signed*
    Date signed
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print