2. Board, authority, or commission on which you would like to serve*

   A separate application must be completed for each position. Information about each Board, Authority and Commission is available online.  

   1. Board of Elections
   2. Human Relations Commission
   3. Vision Committee
4. Last Name*
5. First Name*
6. Middle Name*
8. Residence Address (If your mailing address is different, please enter below.)*
10. City*
11. State*
12. Zip Code*
14. Mailing Address (if different from above)
16. City
17. State
18. Zip Code
20. E-mail Address (Work)*
22. Telephone (Work)*
24. Do you as an individual or the owner of any business have any past due obligations owed to the Unified Government of Athens-Clarke County, such as past due taxes, stormwater fees, utility bills, or fines? *

    1. Yes
    2. No
26. Occupation*
28. Employer*
30. Why are you interested in serving on this board, authority or commission?*
32. What experience, talent, and expertise can you contribute?*
34. Do you have any current or past involvement with this board, authority or commission?*
36. What do you consider the major issues or challenges facing this board, authority or commission?*
38. What professional or community experience do you have related to this position? (Please list positions and their corresponding dates.)*
40. What appointed, elected, or paid positions do you currently hold or have you held with Athens-Clarke County or with the former City of Athens or Clarke County governments? (Please list positions and their corresponding dates.)*
42. Other comments or information. Please attach a brief resume (limit to two pages).*
44. PLEASE NOTE: The Mayor and Commission is tentatively scheduled to interview applicants on the afternoon of Wednesday, February 11, 2026. This will be the ONLY date for interviews. After the deadline for receipt of applications, if you are selected for an interview, you will receive notification on you interview time. Will you be available?*

    1. Yes
    2. No
46. In order to be considered for an interview you must:
    • Be a resident of Athens-Clarke County
    • Have no past due obligations owed by you as an individual or as owner of any business to Athens-Clarke County
48. Electronic Signature*
    By signing above, I confirm that I am informed and I understand the obligation and commitment required by this position. By my signature above, I am also indicating my agreement to follow all applicable requirements of the Georgia Open Records Act and the Georgia Open Meetings Act.
49. Date*
    Date
51. Disclosure
    Georgia law restricts disclosure by the government of unlisted phone numbers, personal email addresses and cell phone numbers and day and month of birth. This information will not be used in Athens-Clarke County publications or websites related to the board or authority to which you are applying unless you consent in writing to such use.
53. Disclosure Consent*

    1. I do consent
    2. I do not consent

    to the use of some or all of the following information in publications or websites related to the board or authority to which I have applied: unlisted phone numbers, personal e-mail addresses and cell phone numbers, and day and month of birth.
55. Electronic Signature for Disclosure Consent*
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field