Hermiston School District
Application for Appointment to School Board Position #5
2016-2017
Name:_________________________________ Phone: _________________________________
Address: ______________________________________________________________________
Email: ________________________________________________________________________
Are you registered to vote? ____ Yes ____ No
Are you a resident of the Hermiston School District? ____ Yes ____ No
If Yes, how long? _________________________________________________________
Previous HSD committee experience: _______________________________________________
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Why are you interested in serving as a member of the school board? _____________________
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Other Remarks: ________________________________________________________________
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