Special District Representative Class IApplication Form

This application has been designed to provide pertinent information about each candidate applying for the position of Class I Special District Representative to LAFCO.  Please read the application carefully and type or print your responses. Feel welcome to attach additional sheets if necessary.

Note: Class I districts include fire protection, community services, and life support districts.

Date Application Submitted:

Name:

Address:

Home Phone:

Cell:

Work:

Name of District You Represent:

Date of Most Current Appointment or Election:

Date Term Expires:

Total Years with District:

Indicate Involvement in Other Agencies/Special Districts:

Total Years Associated with Government/ Community Service: 

List Community Service Activities including Names of Organizations and Dates of Service:

 Have you attended LAFCO meetings? If so, when?

Please explain why you want to serve on the Sonoma Local Agency Formation Commission (LAFCO). 

From your perspective, explain the purpose of LAFCO:

Some content on this page is saved in alternate format. To view these files, download the following software.

Windows Media Player   Windows Media® Player for Windows, Flip4MAC for MAC OSX
Compressed ZIP Archive   WinZip® for downloading compressed files