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Citizen Committee Member Application

2. Citizens interested in serving on any county committee should complete and submit this form.

   Citizens interested in serving on any county committee should complete and submit this form.

4. First Name

5. Last Name

7. Address1

8. Address2

10. City

11. State

12. Zip

14. Are you a Bayfield County Resident?*

    1. Yes
    2. No

15. Have you previously served on a county committe, board or commission?*

    1. Yes
    2. No

16. If yes, which committee, board or commission?

18. Home Phone

19. Cell Phone

21. Email Address *

22. Date
    Date

24. What City/Town/Village are you a Resident of?*

    1. Barksdale
    2. Barnes
    3. Town of Bayfield
    4. City of Bayfield
    5. Bayview
    6. Bell
    7. Cable

    1. Clover
    2. Delta
    3. Drummond
    4. Eileen
    5. Grandview
    6. Hughes
    7. Iron River

    1. Kelly
    2. Keystone
    3. Lincoln
    4. Town of Mason
    5. Village of Mason
    6. Namakagon
    7. Orienta

    1. Oulu
    2. Pilsen
    3. Port Wing
    4. Russell
    5. Tripp
    6. Town of Washburn
    7. City of Washburn

26. Committee

    Please indicate the name of the committee you are submitting an application for.

28. List of Qualifications*

    Please be as specific as possible and include information that is targeted towards the committee, board, or commission you are applying for.

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field