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    Application For Appointment To Boards And Commissions

    Marin County is an Equal Opportunity Employer and Volunteer Center. Minorities, women and individuals with disabilities are strongly encouraged to apply.

  • Please add attachments for additional information if necessary.

  • This is a Public Document Subject to Disclosure Under Public Records Act (Government Code §6250 et seq.)

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    • District Representative 

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    • Housing Representative 
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    • Personal Information

    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.

    • Employment Information

    • Please select one:*
    • Employment Details 
    • Format: (000) 000-0000.
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    • Architect Section 
    • Please check all that apply to you:*
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    • Child Care Section 
    • Please check the group or groups you represent:*
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    • Children Family Section 
    • Which of the following groups do you see yourself representing on the First Five Marin Children and Families Commission?*
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    • Do you live in Marin?*
    • Do you work in Marin?*
    • Have you attended any Commission meetings?*
    • Are you able to attend evening meetings?*
    • Can you commit up to hours per month towards Commission responsibilities?*
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    • Behavioral Health 
    • The California Welfare and Institutions Code that established the Behavioral Health Board requires representation from the following groups. Please check all group(s) for which you qualify that you would like to represent:*

    • In addition, Board Membership must reflect the County's ethnic diversity.

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    • General Questions

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    • Public Authority 

    • Public Authority Governing Board Supplemental Questionnaire

      The In-Home Supportive Services (IHSS) Public Authority of Marin is a public agency serving low-income elderly and disabled residents of Marin who require in-home care to remain safely in their homes. Our goal is to improve the lives of IHSS consumers by recruiting, training, and referring skilled providers.

      We are authorized for a governing board of eleven. No fewer than 50% must be current or former consumers of personal care services paid for through public or private funds.

      The Public Authority is the community forum through which IHSS consumers, providers, and other stakeholders make decisions on issues related to IHSS independent providers service delivery.

      For more information please call (415) 499-1024 or visit www.pa-marin.org.

    • Please complete the following:

    • Are you a current consumer of personal care services paid for with public or private funds?*
    • Are you a past consumer of personal care services paid for with public or private funds?*
    • Are you a current IHSS provider?*
    • Are you a past IHSS provider?*
    • Are you able to attend evening meetings?*
    • Are you able to attend day meetings?*
    • Can you commit up to six hours per month in preparing for and attending meetings? *
    • Do you have a resume listing career and volunteer experience? If so, please attach it.*

    • Do you represent any of the following groups?

      Please check mark any that apply
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    • Women's Commission 

    • Marin Women's Commission Candidate Information Supplemental Questionnaire

      The Marin Women's Commission advocates for equity and parity, diversity, self-sufficiency, leadership and access to resources to enhance the quality of life for Marin County women at all stages of life.

    • The Commission is interested in the talents that each commissioner brings to the table. Please check all the skills that apply.*
    • The Commission's current work is based on the following focus areas developed from our Strategic Plan. Which of these focus areas interest you?*

    • If you need more information, please contact us at email BOS@MarinCounty.org

    • Have you attended any Marin Women's Commission meetings?*
    • Have you met your District Supervisor?*
    • Have you attended Board of Supervisors meetings?*
    • Can you commit up to 5 hours per month?*
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    • Do you represent any of the following?*
    • Please check the following areas of interest to you:*
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    • Attachments

      To attach additional information to this application please use field below. Limit: 3. Allowable file types: doc, docx, xls, xlsx, txt, pdf, jpg, jpeg, bmp, gif, tif, tiff. Maximum file size: 8MB.
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    • NOTE: This application will remain valid for a period of one year. If you wish information on requirements for positions, or on the status of your application, please contact the Clerk of the Board of Supervisors. To submit this application to the Board of Supervisors, click the "Submit" button.

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