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Application for Advisory Board/Committee/Commission

Steps

  1. 1. Step One
  2. 2. Step Two
  • Step One

    1. MyPASCO COUNTY BRANDING INITIATIVE 100

    2. PASCO COUNTY BOARD OF COUNTY COMMISSIONERS

    3. West Pasco Government Center 8731 Citizens Drive

      New Port Richey, FL 34654

    4. Phone: (727) 847-8110

    5. Fax: (727) 847-8969

    6. APPLICATION FOR ADVISORY BOARD/COMMITTEE/COMMISSION

    7. Are you willing to be considered for an alternate Board/Committee/Commission?

    8. Yes or No

    9. Are you a registered voter? (Need only answer if a requirement for the entity for which you are applying.)

    10. Yes or No

    11. I reside in Commission District # (can be found on back of your Voter Registration Card)

    12. Are you a year round resident?

    13. Yes or No

    14. Do you reside in the unincorporated area?

    15. Yes or No

    16. The Board of County Commissioners (BCC) strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Completing this information will help the BCC compile information needed to comply with Florida Statute 760.80.

    17. Choose one:

    18. For Office Use Only

    19. Received ______________

    20. Entered: _________________

    21. Meets Qualifications: Yes ______ No ______ Forwarded to Department: __________

    22. Acknowledgement Sent: ____________ BCC Meeting Date: ____________ Action: _______________

    23. Letter Sent: ________________