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Boards and Commissions Form
Boards and Commissions Form
Please note: Any information submitted through this web site may be subject to disclosure pursuant to a public records request.
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Boards and Commissions Form
Last Name
First Name
City
State
Zip
Phone Number
Email Address
Please select the boards/commissions/councils you would like to be considered for.
Advisory Committee on Persons with Disabilities
Alcohol, Drug Addiction and Mental Health Services (ADAMHS)
Board of Developmental Disabilities
Cleveland-Cuyahoga County Port Authority
College Savings Account Program Committee
Community Based Correctional Facility Board
Cuyahoga County Audit Committee
Cuyahoga County Citizens’ Advisory Council on Equity
Cuyahoga County Corrections Planning Board
Cuyahoga County Economic Development Commission
Cuyahoga County Emergency Medical Services (EMS) Board
Cuyahoga Humane Animal Control Advisory Board
MetroHealth System Board of Trustees
Monument Commission
Western Reserve Area Agency on Aging Board of Trustees
Western Reserve Area Agency on Aging Five County Advisory Council
Why are you interested in serving on this board/commission/council?
What qualities do you possess that would make you a good candidate to serve on this board/commission/council?
What professional experience do you have that would make you a good candidate to serve on this board/commission/council?
Are there any relationships, including but not limited to business or family relationships, that may be perceived as creating a conflict of interest for your service on the Board and/or Commission for which you have applied? If so, please detail the circumstances: