EmailMeForm
This application is for consideration of appointment as a member of a NLC full Policy and Advocacy Committee.
Deadline for application submission is Friday, January 25, 2013.
Name
First
Last
Current Local Elected Office Title:
City/Town:
State:
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Expiration Date of Current Local Elected Office Term:
MM
/
DD
/
YYYY
If your term expires prior to January 1, 2014, do you plan to run again?
Yes
No
POLICY AND ADVOCACY FULL COMMITTEES
To be considered for a member appointment on a Policy and Advocacy Full Committee, select from the list.
Select a Policy and Advocacy Committee:
Select one Committee
Community and Economic Development
Energy, Environment, and Natural Resources
Finance, Administration, and Intergovernmental Relations
Human Development
Information Technology and Communications
Public Safety and Crime Prevention
Transportation Infrastructure and Services
Select a Policy and Advocacy Steering Committee
Preferred Email:
*
Primary means of communicating with NLC
Confirm
Alternate Email:
If you wish to use a personal or other email for communications with NLC. (e.g.) Your Administrative Assistant's email.
Confirm
Preferred Phone:
*
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Daytime phone number
Cell Phone:
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If your preferred daytime phone number is not your cell phone