Appointments

Instructions

Please allot a minimum of 20 minutes to complete the application.
We recommend that you review the form before you begin. This will ensure you have all the required information and requested documents available as the application form cannot be saved.

Biographical Information

*required

Board or Commission Name

Please use a personal email address so that we can identify you even if your employment changes.

Personal Email

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First Name

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Middle Name

Last Name

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Maiden Name

Date of Birth

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US Citizen

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Registered Voter

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MD Resident Since

Format: 1234

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Race

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Gender

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Home Address

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City

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State

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Zip

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Resident County

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Occupation

Employer

Work Address

City

State

Zip

Personal Cell (or Primary) Phone

Format: 123-456-7890

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Alternate Phone

Format: 123-456-7890

Sponsoring/ Nominating Organization

Have you ever been a party (plaintiff or petitioner/defendant or respondent) to any civil, criminal, juvenile or administrative proceeding?
Visit casesearch.courts.md.us to search

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(Specify):

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

Do you hold a Maryland license to practice a profession or trade?

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If Yes, specify type of license and license number:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

Have you ever had a license to practice a profession or trade, whether held in Maryland or another state, revoked or suspended?

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Specify:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

Are you a member, officer or director of any organization, association, or board?

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If Yes, Specify:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

If so, are you engaged in any lobbying activities for that organization?

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Are you a paid lobbyist for any organization?

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(Specify):

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letters, numbers - _ &,.; @ only.
Please do not use enter.

Do you hold, or have you held in the past, an elected or appointed office within Federal, State or local government, or a political party - including appointments by the Governor or Secretary?

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(Specify Office):

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letters, numbers - _ &,.; @ only.
Please do not use enter.

Specify Date(s):

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

Have you filed all Federal and State tax returns that are now due or overdue and are all payments thereupon up to date?

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(Explain):

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

Have Federal, State or local authorities ever instituted a lien or other collection procedures against you?

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(Explain):

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

List the names, business addresses, and business telephone numbers of at least 2 individuals who are familiar with your professional qualifications and who have known you for more than the last five years:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

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Organizational Affiliations:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

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In less than 200 words, please outline why you should be selected to serve on this board:

Valid characters include:
letters, numbers - _ &,.; @ only.
Please do not use enter.

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ATTACHMENTS

Both documents are required for every application.

Please attach your Resume/ CV as a PDF.

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Please attach your Ethics Disclosure form as a PDF.
Download Ethics Form
Download Appointee Ethics Questionaire

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