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Apply for an Advisory Board Position

Please correct the field(s) marked in red below:

Please fill out the following form to apply for a Collier County Board / Committee.

If you have any questions regarding this application please contact Kristi Barlett, Executive Aide to Commissioner Fred Coyle, at (239) 252-8603 or email to kristibartlett@colliergov.net.

Your Name: (Please type your name as it appears on your voters registration)

Home Address
City
Zip Code
Home Phone (Ex: 239-555-5555)
Business Phone (Ex: 239-555-5555)
Fax (Ex: 239-555-5555)
Email Address (In order to receive you application you must enter a valid email address)
Place of Employment
How long have you lived in Collier County?
How Many Months out of the year do you reside in Collier County?
Have you ever been convicted of a felony?
Have you ever been convicted of a felony?
If Yes please explain:
Are you a registered voter in Collier County?
Are you a registered voter in Collier County?

Board Committee Applied For:

Category (If Applicable): Example: Commission District, Developer Environmentalist, Citizen At-Large, etc.

Do you currently hold public office?
Do you currently hold public office?
Do you now serve, or have you ever served on a Collier County board or committee?
Do you now serve, or have you ever served on a Collier County board or committee?

If Yes, please list the boards/committees:

Please list your community activities and positions held: (Example: Civic clubs, neighborhood associations, etc)
Education:
Experience / Backround:
  1. To receive a copy of your submission, please fill out your email address below and submit.