Advisory Board Application

Please fill out the following form to apply for a Collier County Advisory Board / Committee. Once you have filled out all the necessary fields, click the button below.
Name:  

Please type your name as it appears on your voter registration

Home Address:  


City:                                                     Zip Code:
      

Home Phone:               Business Phone:          

  Ex. 239-555-5555           Ex. 239-555-5555

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Important: E-mail address is required to receive a copy of your application.

Email Address:


Board or Committee:
Affordable Housing Advisory Committee Animal Services Advisory Board Bayshore Beautification MSTU Advisory Committee Bayshore/Gateway Triangle Local Redevelopment Advisory Board Black Affairs Advisory Board Building Board of Adjustment and Appeals Coastal Advisory Committee Coastal Storm Risk Management Feasibility Study Ad Hoc Committee Code Enforcement Board Collier County Citizens Corps Collier County Planning Commission Comprehensive Watershed Improvement Program Ad Hoc Committee Contractor’s Licensing Board County Government Productivity Committee Development Services Advisory Committee East of 951 Ad Hoc Advisory Committee Educational Facilities Authority Emergency Medical Authority Floodplain Management Planning Committee Forest Lakes Roadway and Drainage MSTU Advisory Committee Golden Gate Beautification MSTU Advisory Committee Golden Gate City Economic Development Zone Advisory Board Golden Gate Community Center Advisory Board Golden Gate Estates Land Trust Committee Haldeman Creek Dredging Maintenance MSTU Advisory Committee Health Facilities Authority Historical/Archaeological Preservation Board Housing Finance Authority Immokalee Beautification MSTU Advisory Committee Immokalee Local Redevelopment Advisory Committee Industrial Development Authority Infrastructure Surtax Citizen Oversight Committee Land Acquisition Advisory Committee Lely Golf Estates Beautification MSTU Advisory Committee Library Advisory Board Ochopee Fire Control District Advisory Committee Parks and Recreation Advisory Board Pelican Bay Services Division Board Public Art Committee Public Transit Advisory Committee Radio Road Beautification MSTU Advisory Committee Rock Road Improvement Advisory Committee Tourist Development Council Value Adjustment Board Vanderbilt Beach Beautification MSTU Advisory Committee Vanderbilt Waterway MSTU Advisory Committee Water and Wastewater Authority

Category (if Applicable)

i.e., Commission District, Developer Environmentalist, Citizen At-Large, etc.

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Place of Employment:


How long have you lived in Collier County? 1-2 3-4 4-5 5-10 10-15 more than 15

How many months out of the year do you reside in Collier County? 1-3 3-6 6-9 9-12 I am a year-round resident

Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Yes

Do you or your employer do business with the County? No Yes

Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No Yes


Are you a registered voter in Collier County? No Yes

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Do you currently hold an elected office? No Yes


Do you now serve, or have you ever served on a Collier County board or committee? No Yes


Please list your community activities and positions held:

Example: Civic clubs, neighborhood associations, etc.

Education:


Experience / Background