APPLICATION FOR APPOINTMENT
APPLICANTS MUST BE RESIDENTS OF INGHAM COUNTY
Mail completed application before deadline to:
Ingham County Board of Commissioners
P.O. Box 319
Mason, Michigan 48854
(PLEASE DO NOT SUBMIT RESUMES, this application will provide sufficient information)
Application for appointment to:_________________________________________________________________________
Name________________________________________________________________________________________________
Address____________________________________________________City______________________Zip_______________
Home Phone #________________________________________ Work Phone # __________________________________
Occupation ____________________________ Employer____________________________________________________
Business Address ___________________________________City________________________ Zip ________________
Length of residence in Ingham County __________________________________________________________________
Education _______________________________________________________________________________________
___________________________________________________________________________________________________
Relevant Organization / Affiliations ____________________________________________________________________
___________________________________________________________________________________________________
Relevant Employment / Volunteer Experience ____________________________________________________________
______________________________________________________________________________________________________
Military Service ( for Veteran's Affairs Committee Applicants)______________________________________________________________________________________________
______________________________________________________________________________________________________
Brief Statement as to interest in serving on this board / commission ______________________________________________________________________________________________________
______________________________________________________________________________________________________
Have you been convicted of a felony within the past 10 years? Yes___________ No___________
If so, please explain. (You do not need to disclose a felony that has been legally expunged.)__________________________
____________________________________________________________________________________________________
Are there any felony charges pending against you? Yes___________ No__________
If so, please explain. (Answering yes to either question does not necessarily disqualify an applicant.)_________________
____________________________________________________________________________________________________
Date_________________________ Signature______________________________________________________________
APPLICATIONS WILL BE VOID AFTER EXPIRED TERM VACANCIES ARE FILLED
UNLESS STATEMENT BELOW IS SIGNED:
*If not appointed, I wish my application to be kept on file for five months after expired term vacancies are filled and I understand after that time a new application may be necessary.
Signature____________________________________________________________________________________________
*The following questions are voluntary and intended to insure that County Boards and Commission represent a cross section of the community:
Date of Birth_________________________ Race________________________ Sex_______________________________
Current Vacancies