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Citizen Advisory Boards & Committees Application Form
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How long have you lived in Scott County?
What Commissioner District do you live in?
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Board & Committee Information
Select the Board or Committee applying for
Choose all that apply
All Hazards Committee
Community Corrections Advisory Board
Community Development Agency (CDA)
Human Services Resource Council
Library Board of Advisors
Lower MN River Watershed District
Mental Health Local Advisory Council
Parks Advisory Commission
Personnel Board of Appeals
Planning Advisory Commission/Board of Adjustment
Prior Lake-Spring Lake Watershed District
Scott WMO Planning Commission
Solid Waste Advisory Committee
Vermillion River Watershed District
Please state briefly why you are interested in serving on the Committee(s)/Board(s) for which you are submitting an application.
Do you have any special interests, education or training which you feel a particular Committee/Board could use?
Conflict of interest is defined as the participation in any activity, recommended action, or decision from which the individual has or could have the potential to receive personal gain, whether it be direct or indirect.
In accordance with this definition, do you have any legal or equitable interest in any business, however organized, which could be construed as a conflict of interest?
If yes, please provide details below.
Organization Membership Information
Are you currently serving on any other Scott County Citizen Advisory Committee/Board?
If so, provide the name of the Committee / Board:
Are you related to any Scott County Commissioner or to any member on the Committee/Board in which you are interested?
If so, give name and relationship:
Please list other qualifications, experience, information or comments you would like to submit.
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