1.Your Name:

2.What organization/ Agency do you represent and how has that impacted your interest in participating in the Commission on Community Service? (Please write 3-5 sentences)

3.What do you hope to gain from being a member in the commission? (Please write 3-5 sentences)

4.What do you hope to contribute to the Commission and the people it serves? (Please write 3-5 sentences)

5.In what ways has service impacted your personal life/ what was your first experience with service? (Please write 3-5 sentences)

6.Please include a headshot or photo of yourself for use in our monthly Newsletter:

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