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2. First Name
3. Last Name
5. Address1
7. Address2
9. City
10. State
11. Zip
13. Phone number*
15. Email
17. On which board(s) are you interested in serving?*

    1. Any board
    2. Georgetown/Scott County Airport Board
    3. Building Inspection Appeals Board
    4. Friends of the Parks Board
    5. Georgetown Board of Adjustment
    6. Georgetown Ethics Board
    7. Georgetown Housing Authority
    8. Georgetown Human Rights Commission
    9. Georgetown Municipal Water and Sewer Service
    10. Georgetown/Scott County Parks Board
    11. Georgetown/Scott County Planning Commission
    12. Georgetown/Scott County Tourism Board
    13. Lanes Run Business Park Board
    14. Local Governments of Scott County Joint Code Enforcement Board
    15. Property Valuation Local Board of Assessment Appeals
19. Tell us about yourself and what interests you in serving on these boards
21. Describe any previous government or civic experience
23. List any boards or commissions on which you are currently serving
25. Have you reviewed the regularly scheduled meeting dates/times for the boards on which you want to serve? (Info available above)

    1. Yes
27. Are you generally available to meet on those dates/times?

    1. Yes
    2. No
29. Describe any personal circumstances that might make it routinely difficult for you to attend meetings of your preferred board, including any specially called meetings that occur at times other than the regular meetings.
31. How long have you lived continuously in Georgetown?

    1. Less than 1 year
    2. Less than 2 years
    3. More than 2 years
    4. I live in Scott County but not Georgetown
    5. I don't live in Georgetown or Scott County
33. Upload your Resume or CV (optional)
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35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

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