2
Please complete the following. You may use additional sheets as needed.
Community Service
List boards, commissions, committees or community service organizations that you are
currently serving or have served upon, offices held and in what municipality or county.
Employment and Education
List any employment experience or education that, in your opinion, best qualifies you for
this appointment. List job titles, duties (current and past), level of education and any
certificates or degrees you have obtained.
Have you ever worked for Otsego County? ____ Yes ____ No
If yes, please list dates and name(s) of departments.
Personal
Rules of law and ethics prohibit appointees from participating in and voting on matters in
which they may have a direct or indirect financial interest. Are you aware of any
potential conflicts of interest? ____ Yes __ No
If yes, please indicate potential conflicts.
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