Appointment Forms for Membership

Please Note:  Forms must be completed with all Delegates and Alternates listed. Partially completed forms will be treated as a removal of any Delegate/Alternate that is not listed on the new form. Forms should be on county letterhead.

Use this form to appoint members to the Emergency Services Board (ESB) and the RAC, Logger, O&O, EMAC and NG911 Committees. Please complete both Delegate and Alternate areas on the form.

NG911 Committee&#39s three members appointment form
Use this form to appoint up to three (3) members to the NG911 Committee. Please complete both Delegate and all Alternate areas on the form. 
User Committee

Use this form to appoint up to five (5) members to the User Committee. This is the only Committee that has the option to appoint up to 5 members. Remember to list all appointees both new and existing members.

According to the User Committee Bylaws, Discipline = Law enforcement, fire suppression, rescue, EMS, public works, emergency services and other public safety related activities. On 10/19/2017, the User Committee announced the separation of Dispatch into its own category. Not more than 2 appointees from each party may be from the same discipline. Please list all the members appointed by your agency on the form.

Print form on Your Agency Letterhead

Letterhead Example

Click here to learn how to Copy and Paste form onto your agency's letterhead.

JPA - Article II - Section 2:

JPA Appointment

Board and Committee Membership Attendance