MI-Connection Board of Directors Application

2. Full Name:*

4. Street Address:*

6. City:*

8. Home Phone:*

10. Cell Phone:*

12. Email:*

14. Employer:*

16. Title:*

18. Duties:*

20. Hours Available Per Month:*

22. Education:*

24. Business, Civic and Volunteer Experience:*

26. Interests/Skills/Areas of Expertise:*

28. 
    

30. Are there any conflicts of interest or other matters that would create problems or prevent you from fairly and impartially discharging your duties as an appointee of the Mooresville and Davidson town boards? *

    1. Yes
    2. No
32. 
    

34. If yes, please explain:

36. 
    

38. By clicking "I agree," I understand that this application will be kept on file for a two (2) year period only and allow this statement to serve as my agreement in lieu of a signature. *

    1. I agree
40. 
    

42. Thank you for your interest in serving your community. The towns of Davidson and Mooresville sincerely appreciate your interest in serving on the MI-Connection Board of Directors and urge all citizens to nominate qualified individuals for appointment.

44. 
    

46. If you feel your answers on this application do not fully explain your qualifications for service on this board, please upload your resume here and submit it along with your application.

48. Applications due by or on May 14.

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50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

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