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Board of Health Application of Interest to Serve Form
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Please complete the online form below as your Application of Interest to serve on the Peoria County Board of Health.
Name:
*
Home Address:
*
Phone Number:
*
Employer:
Business Phone Number:
Occupation:
Email Address:
List any Boards, Commissions, or Committees on which you currently serve or have served and list dates:
Describe any volunteer, employment, or related experience that you have and list dates:
Explain why you are interested in participating as a Board of Health member:
Describe any areas of expertise or how you feel you may contribute as a Board member:
Please attach resume:
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