Application for Appointment
Madison County Boards And Committees
The Madison County Board of Commissioners invites all Madison County residents to participate in governmental decision
making by serving as a member of a County Board or Committee. The Clerk to the Board of Commissioners maintains a current
list of County appointment opportunities in the Madison County Finance Office. If you have an interest in multiple Boards or
Committees, please complete one application per Board or Committee that you would like to be considered for appointment.
Each application should be completed in its entirety including date and signature. Incomplete applications will not be considered.
Name__________________________________________________________________
Street Address (street name if Po Box)_______________________________________________________________________
Mailing Address (if different)_______________________________________________________________________________
Home Phone_____________________ Work Phone____________________ Email___________________________________
Occupation______________________________________________________________________________________________
Place of Business_________________________________________________________________________________________
Business Address_________________________________________________________________________________________
Do you live within a municipality ___Yes ___No Town Name (if yes)____________________________________________
Do you currently serve on a County Board or Committee? ___Yes ___No
Board Name (if yes)_______________________________________________________________________________________
Please list any appointed positions which you currently hold in Madison County or any municipal government
________________________________________________________________________________________________________
Educational background, special qualifications, related work experience, etc.______________________________________
________________________________________________________________________________________________________
Please list the Board or Committee for which you are seeking appointment
________________________________________________________________________________________________________
Please give a brief explanation of why you would like to serve in this capacity
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
References: Please list the name and phone number of three Madison County residents
________________________________________________________________________________________________________
________________________________________________________________________________________________________
_______________________________________________________________________
Applicant's Signature_____________________________________ Date__________________________
Please return application to: Mandy Bradley, Assistant to the County Manager
Po Box 579
Marshall, NC 28753
Phone: 828.649.2854
Office Hours: 8 a.m.-5 p.m. Mon-Fri.
________________________________________________________________________________________________________
Application Expires (3) three years from the date it is submitted
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