College:        Degree:

Community Involvement:

Check the Boards and/or Commissions you desire to serve on:
Area Agency on Aging                                                         Land Bank Authority
Building Authority                                                                 Mecosta Central Dispatch Board of Authority
Building Board of Appeals                                                    Mecosta Osceola Transit Authority
Brownfield Redevelopment Authority                                   Parks Commission
Commission on Aging Advisory Council                               Planning Commission
Community Mental Health of Central MI                               West Michigan Regional Planning Commission
Department of Health and Human Services                         Other Board(s) or Commission(s):

Why do you wish to serve?

Please submit your completed application to the Osceola County Coordinator's Office.  Applications can be mailed to
301 W. Upton, Reed City, MI 49677 or submitted as an email electronically.

                                                                                                      


Thank you, your form will be kept on file with the County Board of Commissioners for a period of one year.

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FOR OFFICE USE ONLY

Date Received: ____________                                                                                                                        Updated 5/12/15