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Okaloosa County BOCC — December 18, 2012 — Application for Membership on Okaloosa RESTORE Advisory Committee — reading text
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Application for Membership on Okaloosa RESTORE Advisory Committee
Name______________________________________________________________________
Address____________________________________________________________________
Resident of Okaloosa County at least 3 years: ___Yes ___No ( ___City ___Unincorporated)
Position(s) applying for: __Environmental __League of Cities __Business (Chamber)
__Economic/Jobs (EDC) __Education __Fishing/Seafood __Tourism
A. Education (Degrees, Schools, Continuing Education, etc.): (May include in Resume)
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B. Work Experience in the Position Applied For: (May attach resume if desired)
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C. List Three Professional References in the Position Applied For with contact info:
1.__________________________________________________________________________
2.__________________________________________________________________________
3.__________________________________________________________________________
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D. Professional Affiliations and Positions Held (Groups, Societies, Boards, etc):
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E. How much time are you willing to give to this volunteer position? __Hrs per week/month
F. Why do you want to be a member of the Okaloosa RESTORE Advisory Committee?
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G. If not selected for the ORAC, are you willing to serve on a Working Group? __Yes __No
H. I certify that all information in this application is true and accurate. I authorize County staff to verify any
information as they deem necessary and to contact the references I have provided. I also understand that
this is a voluntary (unpaid) position and that I will serve at the will of the Board of County Commissioners. I
further acknowledge that the ORAC falls under the Florida Sunshine Laws (e.g., I cannot discuss ORAC
business with other ORAC members outside a public meeting) and Public Records Laws and I will comply with
those requirements (ORAC members will be briefed on these requirements by the County Attorney).
Name:________________________________ Signature_______________________________ Date________
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