Application for Boards, Committees, and Commissions

If you have questions before applying, click to learn more about the City's Boards, Committees, and Commissions.

Use this form to apply to serve as a volunteer on the City of Hartsville's boards, committees, and commissions. You can also download a PDF of this form. We appreciate your interest in the City of Hartsville.

Your Information

First
Last
Residential Address
City
State/Province
Zip/Postal
Mailing Address
City
State/Province
Zip/Postal
If you're unsure about the following two items, please visit our City Council page for an interactive map of Hartsville's City Council Districts.

Employment Information

Employer Address
City
State/Province
Zip/Postal
Country

Service Questions

If so, list all applicable groups.
If so, list the position and date for each.
If so, list the position and date for each.
If so please list and describe each.

Acknowledgment and Certification

Select "Yes" to assert that you certify that the information above is true and correct. Information on this form will be considered public information.

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