Boards & Commissions Application
RequiredRequired Question(s)
Required 1.
Please fill out the following information:

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.
Please indicate length of residence in Prince William County:


 

50 characters left.
Required 3.
List the Board, Committee, or Commission in which you are interested:

 

350 characters left.
Required 4.
Statement of nominee's qualifications, and/or interest in the appointment:

 

1000 characters left.
Thank you for your submission. If accepted to a Board or Commission, the above information will be included in the Prince William County Boards, Committees, and Commissions Manual.  This information will also be posted on the Prince William County website.  Please contact the Clerk of the Board of County Supervisors at (703) 792-6600 if you have any questions or concerns.