Citizen Participation Application Online Form
**All Fields are Required**
I understand that if appointed, I will serve in a voluntary capacity on this advisory board.

By my entering my typed signature below, I certify that the information on this application is true and complete. I understand that false statements will be cause for denial of appointment. I also understand that, if appointed, the State of Florida may require me to file a financial disclosure with the Putnam County Supervisor of Elections within thirty (30) days of my appointment, and each year thereafter, covering my term of appointment.