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2. Committee & Advisory Board Application
4. Please choose the committee of your choice and then enter your personal information in the spaces provided. Thank-you for your willingness to serve Wayne County.
6. Committee(s) Applying For
8. Name*
9. Email Address*
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. I am a Wayne County Resident*
    -- Select One --YesNo
20. Occupation*
21. Age (Optional)
23. Business / Employer*
24. Position at Place of Employment*
26. Educational Background*
28. Please List Experience (Business, Civic and Any Skills)*
30. Please list other Boards, Committees or Commissions Presently Serving on and the Expiration Date of your service.*
32. References (List three people not related to you)*
34. Additional Information (Optional)
Leave This Blank:


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

    This field is not part of the form submission.

38. Submit

* indicates a required field