Hennepin County Citizen Advisory Board Application
You will have the opportunity to attach files with letters of recommendation and/or your resume as a part of this application process. You must have all document files readily available before you begin this application process.
 
Personal Information
First Name:*    
Middle Initial:  
Last Name:*    
Home Address Business Address                
Business Name:
Address 1:*     Address 1:
Address 2: Address 2:
City:*     City:
State: State:
Zip Code: Zip Code:
County:*     County:
Phone: Phone:
Cell: Cell:
Fax: Fax:
Email:* Email:
       
Commissioner District Number:            Who is my commissioner?
       
Occupation:  
          
Hennepin County will be communicating with you via email. If you do not have an email address, please specify where all communications should be sent:
Please check all that apply:
     
Position you are applying for:
Citizen Advisory Board or Committee:
Category / Area of Representation (if applicable):
          
Qualifications
     
You may attach letters of recommendation and/or your resume. Only .pdf or .doc files may be attached.
 
Resume:

 
Letter of Recommendation:

 
Other Documents:

Resume: Delete Document   Add Another Document
Letter of Recommendation: Delete Document   Add Another Document
Other Documents: Delete Document   Add Another Document
   
   
Statistical Information
The information on date of birth, gender and race/ethnic group is optional and is sought solely for the purpose of compiling statistical reports to the Hennepin County Board of Commissioners on the Citizen Advisory Board appointment process.
 
Date of Birth:
Gender:
     
Race/Ethnic Group:
   
How did you learn about Hennepin County open Citizen Advisory Boards?
 
Some of the information on this application is private. However, some is public, including your name, education and training background, city and county of residence.
 
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