Form Center

2. WC 101 Pilot Program Application for 2023

   WC 101 Pilot Program is designed as an overview of county services in order to develop citizen awareness and understanding of the government’s role in the community. The objective is to provide residents with the information and background necessary to work together for the enhancement of our community.

   The short-term pilot program consists of 4 nights of government information to include presentations, demonstrations, tours, and question-and-answer periods. Each class will meet from 5:30 p.m. to 8 p.m. for four, consecutive Tuesdays from July 11-August 1. Certificates of completion will be presented at the August 28 County Commission meeting.

   Citizens applying for WC101 should be 18 years of age or older; have no criminal  record (other than minor traffic violations); commit to attendance of most classes; and sign all required releases, waivers, and agreement forms. Applicants  agree that a background check will be conducted to verify all information..

   Classes are limited to 20 participants per session. Participants are asked to be on time, as it is necessary to start promptly in order to cover all the scheduled material. Dress is casual, and comfortable footwear is recommended.

   Please complete the application below. Participants will be notified by email and/or a phone call no later than June 30, 2023.            

   Please contact Mary Ellen Miller, maryellen@marketingmel.com or call her at 423-335-7267 for more information.

   Washington County does not discriminate against any applicant because of race, color, religion, sex, sexual orientation, gender identity or national origin.

   
   

4. First and Last Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Date of Birth
16. How long have you lived in Washington County?
18. District you reside in, to find your district/Commissioner click here...
    Washington County Commission Districts
20. District you reside in....
22. Work Phone
24. Mobile Phone
26. Place of Employment
27. Title
29. Tell us why you are interested in WC101
31. How did you hear about WC101?
33. Have you been convicted of an offense, other than a traffic violation? If yes, please explain.
35. List any specific accommodations (including food allergies, dietary restrictions).
37. T-shirt size
38. Date
    Date

    Date
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field