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MWRD Community Partnership Council Application 2026-2028

Applicant Information

Name

Street Address

City

State

ZIP Code

Home Phone

Cell Phone

The following questions will help us to get to know you better.

1. Are you a

Local community leader

Representative or member of a religious organization

Staff member of a community development organization or chamber of commerce

Healthcare professional

Representative of a non-government organization

Other

Please describe

2. Meeting Participation

Are you willing to participate in 4 meetings per year, during MWRD normal business hours, 8:45 a.m.-4:30 p.m., for 2 years?

Please note that you are asked to attend a minimum of 6 of the 8 meetings to maintain your membership in the council.

Yes

3. How do you want to help?

I want to: (check all that apply)

Make thoughtful recommendations on issues affecting MWRD operations, mission, and quality improvement projects

Strengthen communication and collaboration among residents, families, and staff

Promote services to the public

Participate in community outreach events and other educational activities

Other areas

Other areas, please describe

4. Why do you want to serve on the MWRD Community Partnership Council?

5. Briefly describe any experience you may have as a community leader or public speaker.

6. List relevant employment and/or volunteer work experience.

Other affiliations

Board or committee service

Additional information

Attach additional information as desired.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.