Senior Advisory Council

Nomination Application For

Oakland County Senior Advisory Council

Commissioner’s Name

Commissioner’s District

The Oakland County Senior Advisory Council’s primary purpose is to advise the County Executive on the needs and services required by older adults and to point out gaps in the elderly network. The Council is composed of 23 members, including 19 members who are nominated by their County Commissioner. Applicants may also submit an application directly to the Oakland County Health Division. The Council Chairperson may also appoint four members at large. All nominations are submitted to the County Executive for appointment. Two-thirds of members are required to be a minimum of 60 years of age.

First Name

Last Name

Address Line 1:

Address Line 2:

City

ZIP Code

Primary Phone

Type

Email Address

How long have you been a resident of Oakland County?

Date of Birth

I understand that typing my name in the signature box below creates an electronic signature that has the same validity as actually signing the form and either faxing it back or mailing it back via the U.S. Postal Service.

Applicant's Signature

Contact Information