CARROLL COUNTY MARYLAND
225 N. Center Street
Westminster, Maryland 21157-5194
Westminster 410-386-2043
Baltimore 1-888-302-8978
FAX 410-386-2485
MD Relay Service 7-1-1/800-735-2258
Board of County
Commissioners
Edward C. Rothstein, President
C. Richard Weaver, Vice President
Stephen A. Wantz
C. Eric Bouchat
Dennis E. Frazier
Application for
Appointment to any Board or Commission
If you are a resident of Carroll County and would like to serve on one of the County’s Boards or
Commissions, please complete this application and click the submit button at the bottom of the page.
Last Name
Phone Number
Are you currently a resident of Carroll County, MD?
First Name
Address
Email Address
Are you currently at least 18 years of age?
Have you ever been convicted of a felony?
Yes
No
Yes
No
For which Boards or Commissions are you applying?
Why would you like to participate on each Board or Commission you selected?
Please attach a letter of interest with a resume or work history statement sharing your work life experiences (3 page
maximum - PDF format required).
Yes
No
Choose One
Attach File
Do you have any relatives, including in-laws and members of your immediate or extended family)
currently working for Carroll County Government or Carroll County Government partners?
Yes
No
Were you a previous member or are you a current member of a Board or Commission?
Yes
No
Important Notes
Boards and Commissions members may be required to complete an Ethics Financial Disclosure Form. In addition, particular
boards may require State of Maryland Board training and/or County training.
Your application will be kept on file for two (2) years from the date of submittal.
Changes in availability can occur without notice; some boards listed may not have open positions.
Please call 410-386-2043 to verify.
By submitting this form, you are attesting to the accuracy of the provided information, and agree that it may be used by the
Board of County Commissioners in considering your nomination to a Board or Commission.
Agree
Submit