Please complete the online form below.

Personal Information

Name:*

Home Address:*

Home Phone Number:*

Business Address:*

Business Phone Number:*

Occupation:*

Email Address:

Residency Information

Length of Residency in Dickinson County*

Are you a registered voter:*

Yes

No

Education and Experience:

Education History:

Please describe any relevant work, educational or life experience:*

General Planning Commission Questions

In your opinion, what is the purpose and goal for the Dickinson County Planning Commission?*

Are you familiar with Dickinson County's land use plan?*

Yes

No

If yes; What role do you believe this plan should play in the future of Dickinson County?

Describe the role of each of the following:

Applicant:*

Developer:*

Planning and Development Staff:*

Planning Commission:*

Organization Membership Information

Are you currently serving on other Boards, Commissions, or Committees?*

Yes

No

If yes, which:

Have you served on a Board, Commission, or Committee before?*

Yes

No

If yes, which:

Please list organization memberships and positions held:

Please List Areas of Special Interest