Submit Board Application
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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
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:
Attach an application form!
File type not allowed. Allowed types are .doc, .docx, .pdf, .xls, .xlsx, .txt
I have attached my application form and am ready to continue
Step 2: Complete demographic and personal information**
Salutation
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:
Salutation is required.
Select One...
D.O.
Dr.
Esquire
Gen.
Hon.
Judge
Maj. Gen.
Miss
Mr.
Mrs.
Ms.
President
Rabbi
Rep.
Rep. Honorable
Rev.
Sen.
Senator
Sgt. Maj.
First Name
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:
First name is required.
Middle Name:
Last Name
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:
Last name is required.
Suffix:
Preferred Name/Nickname:
Spouse Name:
Email Address
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:
Email address is required.
Invalid Email Format
Cell Phone Number (999) 999-9999
Self Description
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:
Please select at least one self description option.
Prefer not to disclose
Native-American
Asian-American
Pacific Islander
Black/African-American
White/Caucasian
Hispanic-American
American Woman
Physically Disabled
Gender
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:
Gender is required.
--Select--
Male
Female
Prefer not to disclose
Specify the preferred mailing address
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Please select the preferred mailing address.
Business
Residential
Specify the preferred method of contact
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:
Please select the preferred method of contact.
Email
Mail
Residential Address
Address line 1
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Resident Address 1 is required.
Address line 2:
City
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:
Resident city is required.
State
*
:
Resident state is required.
--Select--
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
OTHER
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
County
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Resident county is required.
Zip
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Resident zip-5 is required.
Home Phone Number (999) 999-9999:
Business Address
Address line 1
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:
Business Address 1 is required.
Address line 2:
City
*
:
Business city is required.
State
*
:
Business state is required.
--Select--
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
OTHER
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
County
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:
Business county is required.
Zip
*
:
Business zip-5 is required.
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:
Yes
No
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:
Yes
No
Are you a registered Florida voter?
If "Yes" list:
Yes
No
County of registration:
Select One...
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Miami-Dade
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
Santa Rosa
Sarasota
Seminole
St. Johns
St. Lucie
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington
Current party affiliation:
Are you or have you ever been a member of the armed forces of the United States:
Yes
No
Step 3: Select board seats to apply for
Board Name:
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:
Select One...
ADVISORY COUNCIL FOR THE WEBSITE INFORMATION CLEARINGHOUSE ON DEVELOPMENTAL DISABILITIES
ALZHEIMER'S DISEASE ADVISORY COMMITTEE
ATLANTIC STATES MARINE FISHERIES COMMISSION
BIOMEDICAL RESEARCH ADVISORY COUNCIL (BRAC)
BLOOD CLOT AND PULMONARY EMBOLISM POLICY WORKGROUP
BOATING ADVISORY COUNCIL
CANCER CONTROL & RESEARCH ADVISORY COUNCIL, FLORIDA
CAREERSOURCE FLORIDA, INC., BOARD OF DIRECTORS
CHILDREN AND YOUTH CABINET
CITIZENS PROPERTY INSURANCE CORPORATION BOARD OF GOVERNORS
COMMISSION ON ETHICS
COMMISSION ON MENTAL HEALTH AND SUBSTANCE USE DISORDER
COUNCIL FOR EARLY GRADE SUCCESS
COUNCIL ON THE SOCIAL STATUS OF BLACK MEN AND BOYS
DEFERRED COMPENSATION ADVISORY COUNCIL
DIRECTOR OF CAPITOL POLICE
EDUCATION COMMISSION OF THE STATES (Florida Members)
ENTERPRISE FLORIDA INC., BOARD OF DIRECTORS
FLORIDA ABLE, INC.
FLORIDA ALLIANCE TO END HUMAN TRAFFICKING, BOARD OF DIRECTORS (DSO that supports the Statewide Council on Human Trafficking)
FLORIDA CENTER FOR BRAIN TUMOR RESEARCH SCIENTIFIC ADVISORY COUNCIL
FLORIDA CLERKS OF COURT OPERATIONS CORP. EXECUTIVE COUNCIL
FLORIDA COMMISSION ON THE STATUS OF WOMEN
FLORIDA COUNCIL ON ARTS AND CULTURE
FLORIDA CYBERSECURITY ADVISORY COUNCIL
FLORIDA DEFENSE SUPPORT TASK FORCE
FLORIDA EDUCATION FUND BOARD OF DIRECTORS
FLORIDA FAITH-BASED AND COMMUNITY-BASED ADVISORY COUNCIL
FLORIDA FILM AND ENTERTAINMENT ADVISORY COUNCIL
FLORIDA GREENWAYS AND TRAILS COUNCIL
FLORIDA HIGH SCHOOL ATHLETIC ASSOCIATIONS PUBLIC LIAISON ADVISORY COMMITTEE
FLORIDA HISTORIC CAPITOL MUSEUM DIRECTOR
FLORIDA HISTORICAL COMMISSION
FLORIDA HOUSING FINANCE CORPORATION BOARD OF DIRECTORS
FLORIDA IS FOR VETERANS, INC., BOARD OF DIRECTORS
FLORIDA MUSEUM OF BLACK HISTORY TASK FORCE
FLORIDA SMALL BUSINESS DEVELOPMENT CENTER NETWORK STATEWIDE ADVISORY BOARD
FLORIDA TALENT DEVELOPMENT COUNCIL
FLORIDA VETERANS' HALL OF FAME COUNCIL
GOVERNMENT EFFICIENCY TASK FORCE
GRADUATE MEDICAL EDUCATION COMMITTEE
GULF STATES MARINE FISHERIES COMMISSION
HEALTH CARE INNOVATION COUNCIL
HOUSING DEVELOPMENT CORPORATION OF FLORIDA, BOARD OF DIRECTORS
I-STREET LIVING LAB ADVISORY BOARD
MARJORY STONEMAN DOUGLAS HIGH SCHOOL PUBLIC SAFETY COMMISSION
PUBLIC SERVICE COMMISSION NOMINATING COUNCIL, FLORIDA
RARE DISEASE ADVISORY COUNCIL
SCRIPPS FLORIDA FUNDING CORPORATION BOARD OF DIRECTORS
SEAGRASS RESTORATION TECHNOLOGY DEVELOPMENT INITIATIVE TECHNICAL ADVISORY COUNCIL
SOUTHEASTERN INTERSTATE FOREST FIRE PROTECTION COMPACT ADVISORY COMMITTEE
SOUTHERN STATES ENERGY BOARD (Florida Members)
SPACE FLORIDA BOARD OF DIRECTORS
STATE COUNCIL ON INTERSTATE EDUCATIONAL OPPORTUNITY FOR MILITARY CHILDREN
STATE EXECUTIVE COMMITTEE (Republican)
STATEWIDE COUNCIL ON HUMAN TRAFFICKING
STATEWIDE COUNCIL ON OPIOID ABATEMENT
STATEWIDE DRUG POLICY ADVISORY COUNCIL
TASK FORCE ON THE MONITORING OF CHILDREN IN OUT-OF-HOME CARE
THE INITIATIVE TECHNOLOGY ADVISORY COUNCIL
THE TASK FORCE ON ABANDONED AFRICAN-AMERICAN CEMETERIES
TOBACCO EDUCATION AND USE PREVENTION ADVISORY COUNCIL
TRIUMPH GULF COAST, INC., BOARD OF DIRECTORS
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
Please select at least one seat!
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:
File type not allowed. Allowed types are .doc, .docx, .pdf, .xls, .xlsx, .txt
Additional file 2:
File type not allowed. Allowed types are .doc, .docx, .pdf, .xls, .xlsx, .txt
Additional file 3:
File type not allowed. Allowed types are .doc, .docx, .pdf, .xls, .xlsx, .txt
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.