Fillable B G B B B/C A County Executive (Harford County Government)

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B G B B B/C A County Executive (Harford County Government)

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BROWSE HARFORD COUNTY GOVERNMENT (MD) FORMS

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B G
HARFORD COUNTY EXECUTIVE
410.638.3350
I
410.879.2038
I
TTY Maryland Relay 711
I
www.harfordcountymd.gov
220 South Main Street, Bel Air, Maryland 21014
THIS DOCUMENT IS AVAILABLE IN ALTERNATIVE FORMAT UPON REQUEST
B B
DIRECTOR OF ADMINISTRATION
B/C A
County Executive and County Council members will review the following information for your possible
nomination to a board or commission. is data will become public information.
Please return the completed form to the address below.
Board or Commission Preference(s) (See other side)
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Are you a registered voter? yes no Democrat Republican Unaliated
Some county boards and commissions require a balance of political-party representation.
Name ___________________________________________________________________________
Last First Middle
Street Address ___________________________________________________________________________
Street Address
___________________________________________________________________________
City State Zip Code
Home Phone ____________________________ Oce Phone _______________________________
Email ___________________________________________________________________________
Occupation ___________________________________________________________________________
Place of Employment ___________________________________________________________________________
Education/Background ______________________________________________ Race_______________________
Aliations (Civic/Organizations) ___________________________________________________________________________
Special Interests ___________________________________________________________________________
Other Pertinent Information ___________________________________________________________________________
To the best of my knowledge, the above information is correct and may be used by the County Executive and the
County Council in considering my nomination to a board or commission.
Signature _____________________________________________________ Date ________________________________
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signature
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THIS DOCUMENT IS AVAILABLE IN ALTERNATIVE FORMAT UPON REQUEST
H C B  C
Adult Public Guardianship Review Board
Advisory Board on Aging
Agricultural Land Preservation Advisory Board
Animal Control Advisory Board*
Board of Electrical Examiners*
Board of Estimates*
Board of Ethics*
Building Code Board of Appeals
Citizens Care & Rehabilitation Board
Commission on Disabilities
Commission on Veterans’ Aairs*
Commission for Women
Criminal Justice Coordinating Council*
Cultural Arts Advisory Board
Deer Creek Scenic River Advisory Board
Department of Social Services Advisory Board
Economic Development Advisory Board*
Economic Development Agricultural Advisory Board*
Economic Development Tourism Advisory Board
Environmental Advisory Board*
Harford Center Board of Directors
Harford County Community Mediation Commission*
Harford Soil Conservation Board of Supervisors*
Healthy Community Planning Board
Historic Preservation Commission*
Human Relations Commission*
HVAC Board
Liquor Control Board
Local Management Board *
Mental Health & Addictions Advisory Council
Parks & Recreation Advisory Board*
Personnel Advisory Board*
Planning Advisory Board*
Plumbing Board*
Property Tax Assessment Appeal Board
Public Library Board of Trustees
Public Works Advisory Board*
Towing Appeals Board*
Youth Commission
*Term runs concurrent with County Executive’s Administration
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B G B B BC A County Executive (Harford County Government)

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Completed 17 July 2020

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