The Florida Senate

Submit Board Application

*Required fields

Step 1: Attach completed application form (Download application form)

Note: Files must be 2 MB or less in size (Please contact the Appointments office if you have a larger file to upload)
Application form*:    

Step 2: Complete demographic and personal information**

Salutation*:  First Name*:  Middle Name: Last Name*:  Suffix: Preferred Name/Nickname: Spouse Name: Email Address*:   
Cell Phone Number (999) 999-9999
Self Description*:  




American Woman
Physically Disabled

Gender*: 
Specify the preferred mailing address*:   Specify the preferred method of contact*:  

Residential Address

Address line 1:  Address line 2: City:  State: 
County:  Zip:  Home Phone Number (999) 999-9999:

Business Address

Address line 1:  Address line 2: City:  State: 
County:  Zip:  Business Phone Number (999) 999-9999: Fax Number (999) 999-9999:

Personal Information

Have you ever used or been known by any other legal name?
If "Yes" list:

If you are a naturalized citizen, date of naturalization (MM/DD/YYYY): Since what year have you been a continuous resident of Florida?: Are you a United States Citizen?
If "No" list countries:
Are you a registered Florida voter?
If "Yes" list:
County of registration: Current party affiliation:

Are you or have you ever been a member of the armed forces of the United States:

Step 3: Select board seats to apply for

Board Name:*:
 
Select seats to add:*:

 

 

Your Selected Seats (select item and click "Remove" to remove from list)

If you submit without selecting at least 1 seat your data will not be saved
 

Step 4: Attach additional documents (optional)

Note: Files must be 2 MB or less in size (Please contact the Appointments office if you have a larger file to upload)
Additional file 1:  

Additional file 2:  

Additional file 3:  

Step 5: Submit board application



*Please don't close your browser during upload*
Notes
**This information will be used to provide demographic statistics and is not requested for the purpose of discriminating on any basis.