Become a Board Member Download the Board Application Here! Or fill out the form below and print it and mail it to our offices. Board Member Application Name*Date*AddressCity*State*Zip Code*Home Telephone Number*Work Telephone NumberWork E-MailPersonal E-Mail*Occupations - Title and Description*Business Street AddressCityStateZip CodeOther Affiliations/Board ServiceDo you have a family member with a Developmental Disability?YesNoIf so, what is your relationship?Why are you seeking appointment to the Stone County Developmental Disability Board?Give a brief description of your education, experiences, and/or any other special skills or qualities that will help the Commission in its selection of Stone County SB40 Board members.I have been made aware of the responsibilities of members of the Stone County Developmental Disability Board, and am willing to make a commitment to the Board as a member. Signature*Date*Print Form
