Application Form

Please fill out the following form to apply for a board.


If you are experiencing problems submitting this form, please download and fill out the application form below and email the completed version, along with a copy of your resume or bio to boardsandcommissions@nc.gov

Click here to download the form.

Select a Board/Commission
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Basic Information
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Home Address
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Mailing Address
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Contact Information
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Education
High School:*
School Name
Graduated

Year Graduated

College:
College Name

Graduated


Year Graduated


Degree

Post Graduate:
College Name

Graduated


Year Graduated


Degree

Employment Status
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References
Reference 1:
Name

Title


Organization


Relationship


Phone Number


Email

Reference 2:
Name

Title


Organization


Relationship


Phone Number


Email

Reference 3:
Name

Title


Organization


Relationship


Phone Number


Email

Personal Information
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Attachments
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I certify that I have given true, accurate and complete information on this form to the best of my knowledge. I authorize the Governor’s Office to investigate any and all statements made in this application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for rejection of my application. I further understand that dismissal upon appointment shall be mandatory if fraudulent disclosures are given to meet position qualifications (Authority: G.S. 14-122.1.)
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