2. If you reside in Randolph County and are willing to volunteer your time and knowledge to your community serving on a board or committee, please complete and submit this form.

   Application for Randolph County Boards/Committees

4. Please note all application materials submitted will become public record and may be disclosed under the NC Public Records Law.
8. Applicant Full Name*
10. Address
12. City
13. State
14. Zip Code
16. Applicant Phone Number
17. Email Address
21. Emergency Contact
23. Emergency Contact Name
24. Phone Number
28. Please list professional and previous board experience:
30. Is there a particular board or committee on which you wish to serve?
32. Why do you wish to be a member of this board or committee?
34. What experience, background, or knowledge would you bring as a member of a board or committee?
36. Because the frequency of meetings and the meeting times vary depending on the board/committee, do you have any limitations for attending meetings?
40. Do you object to the County Manager’s Office obtaining your criminal background history?*

    1. Yes

    1. No
42. By submitting this form, you confirm that the information provided is accurate.

    1. Confirm
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field