Appointment Forms for Membership

Please Note:  Partially completed forms will be treated as an official removal of any Delegate/Alternate that is not listed on the new form. Forms should be on county letterhead.
Appointment form for the Board and Committees

Use this form to appoint two (2) members to the Emergency Services Board or the Regional Advisory Committee, Logger, and Emergency Management Advisory Committees. Please complete both Delegate and Alternate areas on the form.


NG911 and Owners and Operators Committee&#39s three members appointment form
Use this form to appoint up to three (3) members to the Next Generation 9-1-1 or Owners & Operators Committees. Please complete the Delegate and at least one Alternate area on the form. 
User Committee Appointment Form

Use this form to appoint up to five (5) members to the User Committee. Not more than two (2) appointees from each party to the CMESB may be from the same discipline*. Please list all members appointed by your agency on the form, 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. Note: The User Committee announced the separation of Dispatch into its own category on 10/19/2017.


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