Forms for Districts

Download this form in Word | PDF.

Please note that the PACD Executive Board must take official action to appoint each committee member. Volunteering and/or making a nomination does not guarantee a committee appointment by the PACD Executive Board.

NOMINATION OR VOLUNTEER

___ I am personally nominating someone else to serve on this committee. This individual knows of my nomination and is interested in serving.

Your Name and District:

________________________________________________

___ I would like to personally be considered to serve on (a) PACD Committee(s).

NOMINEE/VOLUNTEER INFORMATION

Name: ________________________________________________

Conservation District: _____________________________________

Position with the district:

___ District Director
___ Associate Director
___ District Staff (Position: ________________________________)

Please consider me/this individual for the following committee(s):

___ Legislative
___ Education and Outreach
___ Ways and Means
___ District Employees
___ Conservation
___ Operations

Contact Information

Address: ______________________________________________

_____________________________________________________

Phone: _______________________ Fax: ____________________

e-mail: ________________________________________________

Please return this form to the PACD office.

Mail to: PACD, 25 North Front Street, Harrisburg, PA 17101 Fax to: (717) 238-7201

Questions? Call PACD at (717) 238-7223