Name:
Address:
City: State: ZIP:
Home Phone: Work Phone:
Email:
Race: Ethnicity:
School, College or University of highest level of education:
Profession:
Are you a District Employee? Yes No
Are you currently serving on any other Board Advisory Committee? Yes No
Do you commit to attend at least four (4) meetings per year? Yes No
Please provide information regarding any special degrees, interests, expertise, or experience you possess in business, finance, construction, or safety and security that would aid you as a committee member:
Other qualifications to be considered:
Why are you interested in serving on this committee?
How did you hear about this committee?
Are you currently doing business with the School Board of Lee County or the School District of Lee County? Yes No
If yes, please describe:
Do you have an employment relationship with a company/individual currently doing business with the School Board of Lee County or the School District of Lee County? Yes No
If yes, please describe:
Do you have a contractual relationship with a company/individual currently doing business with the School Board of Lee County or the School District of Lee County? Yes No
If yes, please describe:
Please be advised that the information you provide on your application, once submitted, is public record under Chapter 119, Florida Statutes, the Public Records Act, commonly known as the Sunshine Law. If you are aware of an exemption to the Public Records Act that requires your information to be maintained as private, please provide that basis in writing to the District.
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