Washington County Executive Committee Application

Biographical Data Sheet

(for Nominating Committee Use)

 

Date:________________________________

 

 

Name:___________________________________________________________________

 

Address:_________________________________________________________________

 

Telephone: Home__________________________ Work___________________________

 

Employment______________________________________________________________

 

Professional Skills/Training__________________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

Volunteer experience (Attach additional sheets, if necessary):

 

Years                           Organizations                            Position/Activity

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

Additional civic and fraternal activities__________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

Specific awards, citations:___________________________________________________

 

________________________________________________________________________

 

________________________________________________________________________

 

Availability for meetings: Morning ___________  Lunch ____________
 

Please return to WCEA, 28 Center Street, Machias, ME 04654.