New Membership Application — Middle Snake Regional Water Resource Commission

For consideration of membership to the Middle Snake Regional Water Resource Commission, please fill out and submit the information below…

Name

First Name

Last Name

County of Residence

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

How did you hear about this commission?

General Questions

1. Why are you interested in serving on this this commission?

2. How much time would you be able to devote to this advisory group?

3. What do you feel are the major water quality and quantity concerns of the area?

4. What do you feel would be your role if you were to serve on this advisory group?

5. Would you be able/willing to serve for up to four years and possibly longer?

6. Have you ever been involved in water quality and quantity planning activities? If so, please provide detailed information.

7. Is there any additional information you would like to submit?

Date

YYYY

Signature (type name and check box below)

Please check box to indicate submission of signature.