Application for Advisory Board/Committee/Commission

Advisory Board Information

Please ensure there is an opening for the advisory board you're applying for and that you meet its requirements.

Select Advisory Board

Seat you're interested in

All members must be year-round residents of Manatee County. ELMAC opportunities are for the following seats:

Member of an Environmental Group

Member engaged in Banking, Finance or Real Estate

Member with Education in Active Outdoor Sports

Member employed by the Manatee County School Board

Member of the Florida Engineering Society

Seat you're interested in

Applicant Information

Is your mailing address the same as your home address?

Yes

Home Phone

Work Phone

Phone

Extension

Cell Phone

Occupation (if retired, please indicate)

Business Name

Are you registered to vote in Manatee County? (This is required for some boards/commissions)

Yes

Which County Commission District do you reside in?

District 1

District 2

District 3

District 4

District 5

Please note that District boundaries have recently changed. Find your current District using the Resident Information Tool.

Do you reside in unincorporated Manatee County?

Yes

View this map to see if you reside in unincorporated Manatee County.

Which city do you reside in?

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing the information below will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender

Male

Female

Race

African American

Asian American

Caucasian

Hispanic American

Native American

Additional Information

List any governmental Advisory Boards/Committees/Commissions on which you currently serve.

List any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Please attach a current and comprehensive resume or curriculum vitae, if applicable. Upload your resume/CV

Click Here to Upload

Supplemental Questions for Applicants to the Manatee County Investment Policy Advisory BoardPlease complete all questions with current and accurate information.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government?

Yes

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest?

Yes

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel?

Yes

Detail your education in subjects or courses related to investment practices, products, and strategies.

Describe your specific background and experience in any or all of the following:: Development and review of investment policies and accompanying reports; managing investment portfolios and total value of said portfolio; maintaining investment objectives of safety of capital, liquidity of funds, and investment income; consideration of economic outlook, risks and investment results and work with federal, state, or local government entities.

Please attach a current and comprehensive resume or curriculum vitae, if applicable. Upload your resume/CV:

Upload File(s)

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Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory BoardPlease complete all questions with current and accurate information.

Are you or any of your immediate family members affiliated with any agency (see below) that receives Children's Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency's Board of Directors; or contract with the agency

Yes

Explain your affiliation with the above agencies:

The Children’s Services Advisory Board has an annual retreat which is generally held on the 1st or 2nd Friday of October from 8:30 am to 3:30 pm or later. If you are appointed, will you be available on these dates and times?

Yes

If no, please explain

The Children's Services Advisory Board has monthly meetings which are generally on the 3rd Wednesday of each month from 3:00 pm to 5:00 pm or later. If you are appointed, will you be available at these dates and times?

Yes

Please explain.

The Children’s Services Advisory Board is responsible for reviewing and scoring funding applications submitted by non-profit agencies. This generally occurs during the months of February, March, April, and May each year, and meetings are held each Wednesday from 3:00 pm to 5:00 pm or later. The time commitment for preparing for the meetings by reviewing and scoring funding applications takes members an average of 10-15 hours per week. If you are appointed, will you be available to attend the weekly meetings and commit to 10-15 hours per week to review and score funding applications?

Yes

If no, please explain.

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory BoardPlease complete all questions with current and accurate information.

An application to the Health Council of West Central Florida requires a current and comprehensive resume or curriculum vitae. Upload your resume/CV

Click Here to Upload

What is your field of expertise? (Please indicate all that apply)

Healthcare

Mental Health

Substance Abuse Care

Social Services

Higher Education

Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Practicing Physician

Please explain

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly?

Yes

Please explain

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes

Which ones? (Include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae. Upload your resume/CV

Click Here to Upload

NOTE: Please do not include any information on this document that you wish to not be shared with the public as this document and all of its contents will become public record upon submission.

Additional Questions

Yes

Please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest?

Yes

Please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel?

Yes

Please explain.

Important Information

For questions regarding a specific advisory board, committee, or commission, including the duties and requirements, please contact the County staff liaison listed on that board’s webpage.
Certain advisory boards, committees, and commissions have specific membership requirements including a valid voter registration card, financial disclosure and/or the submission of other information.
Attendance is required at advisory board meetings. Three unexcused absences may be grounds for removal.
Florida State Statute 119.07 designates this application as a public document to be made available for anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of this statute, please explain below.
Advisory boards, committees or commissions having the authority to make factual determinations, review permit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereign powers and members are prohibited by Florida law from holding more than one such position. If you currently hold another state, municipal or county government appointment, County

Florida State Statute 119.07 designates this application as a public document to be made available for anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of this statute, please explain.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided.

Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

Please sign and date below
I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact Carmine DeMilio at (941) 792-8784 Ext. 8203 or carmine.demilio@mymanatee.org three days before a meeting.