Form Center

2. Individuals interested in serving on a McKinleyville Municipal Advisory Committee (MMAC) subcommittee must complete this application form. Please be concise.

   For additional questions regarding subcommittee membership, please email COB@co.humboldt.ca.us or call 707-476-2390.

   To learn more about the MMAC and its subcommittees, please visit the MMAC webpage:  https://humboldtgov.org/238/McKinleyville-Municipal-Advisory-Committ

   Please note that your application is subject to the California Public Records Act and disclosure requirements. 

4. First Name*
5. Last Name*
7. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. Email*
17. Telephone (Home/Cell)*
18. Telephone (Work)
19. Fax
21. Occupation*

    Please list your current occupation and employer.

23. Subcommittee Name*

    Please list the name of the MMAC subcommittee you have interest in serving on. 

25. Personal References*

    Please list two references who can speak to your qualifications and ability to serve on a MMAC subcommittee. Include their name, title/affiliated organization, their relationship to you, their phone number and email address.

27. Prior Advisory Board or Board of Directors Experience*
    -- Select One --YesNo

    Select one.

28. Resume*

    Please upload a current resume.

30. Why are you interested in serving on this McKinleyville Municipal Advisory Committee subcommittee?*

    Please write a brief statement describing why you are interested in serving on this subcommittee.

32. Acknowledgement*

    1. Confirm

    By checking this box and submitting this application, I declare under penalty of perjury under laws of the State of California that the above is true and correct.

34. Type or Sign Your Name*
35. Date*

    Applications will be kept on file for two years.

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field