Application for Reappointment
Madison County Boards And Committees
Thank you for your service to Madison County by serving as a County Board or Committee Member. If your term is
scheduled to expire in the next three months and you are interested in continuing to serve on the board of which you
are currently a member, please complete the reappointment application. Please complete one application per Board
or Committee that you would like to be considered for reappointment. 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)_________________________________
Please list all Madison County Boards or Committees of which you are currently a member
___________________________________________________________________________________________
Please list the Board or Committee for which you are currently seeking reappointment
____________________________________________________________________________________________
Current term appointment date___________________ Current term expiration date______________________
Please give a brief explanation of why you would like to continue serving in this capacity
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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.
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signature
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