Application for a board or commission

Thank you for your interest in serving your fellow Washingtonians. We will send you a confirmation email after receiving your completed application.

Please note that pursuant to the state's Public Records Act (RCW 42.56), applications submitted for these appointments are subject to public disclosure. If you have any questions, call (360) 902-4111. (* Denotes required field)

Please attach your resume and any additional materials you would like considered at the bottom of this form. We ask that you do not email, mail, or fax additional copies of your application, resume, or supplementary materials to the Boards & Commissions Office.

Board Information

Please choose the board or commission for which you would like to be considered:

Please choose the position you are interested in:

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If you cannot find the board or commission above, please use the space below to type the name:

Please type the position you are interested in

Are you currently a member of this board?

Position Number

Applicant Information

Provide full legal name

First Name

Middle Name

Last Name

Preferred Name

Alias, maiden name, or nick name

Preferred Method of Contact

Primary Phone

Email Address

***

Address Line 1

Address Line 2

City

State

Zip Code

County

Legislative District (1-49)

Congressional district in which you reside (1-10)

Why do you want to serve on this board or commission?

Board/commission meetings are held during the day. Are you able to come participate in day meetings?

Board/commission meetings are held during the day. Are you able to come participate in day meetings? NoBoard/commission meetings are held during the day. Are you able to come participate in day meetings? Yes

Have you been a registered lobbyist or have you employed a lobbyist during the past five years?

Have you been a registered lobbyist or have you employed a lobbyist during the past five years? NoHave you been a registered lobbyist or have you employed a lobbyist during the past five years? Yes

If yes, did you receive any compensation?

If yes, did you receive any compensation? NoIf yes, did you receive any compensation? Yes

Could you or your family be affected financially by board or commission decisions?

Could you or your family be affected financially by board or commission decisions? NoCould you or your family be affected financially by board or commission decisions? Yes

If yes, please explain

Employment/Experience

Job Title

Employer

Address Line 1

Address Line 2

City

State

Zip Code

County

Work Phone

Work Email

Statistical Information

Date of birth is required from all applicants to facilitate a background check.

Birth Date

Gender

Race information

American Indian or Alaskan Native

Asian

Hispanic/Latino

Black/African American

Native Hawaiian/Other Pacific Islander

White Caucasian

Veteran information

Have you ever been on active duty with the U.S. Armed Forces?

Have you ever been on active duty with the U.S. Armed Forces? NoHave you ever been on active duty with the U.S. Armed Forces? Yes

Branch of Service

Type of Discharge

Campaigns

Please attach your resume and any additional materials you would like considered. We ask that you do not email, mail, or fax additional copies of your application, resume, or supplementary materials to the Boards & Commissions Office.
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Application for a board or commission

Thank you for your interest in serving your fellow Washingtonians. We will send you a confirmation email after receiving your completed application.

** Please note that pursuant to the state's Public Records Act (RCW 42.56), applications submitted for these appointments are subject to public disclosure. If you have any questions, call (360) 902-4111.** (* Denotes required field)

Please attach your resume and any additional materials you would like considered at the bottom of this form. We ask that you do not email, mail, or fax additional copies of your application, resume, or supplementary materials to the Boards & Commissions Office.

Board Information

Applicant Information

Provide full legal name

Employment/Experience

References

Reference 1

Reference 2

Reference 3

Reference 4

Personal Information

Statistical Information

Date of birth is required from all applicants to facilitate a background check.

Race information

Veteran information

Please note that pursuant to the state's Public Records Act (RCW 42.56), applications submitted for these appointments are subject to public disclosure. If you have any questions, call (360) 902-4111. (* Denotes required field)