OFFICE OF THE SECRETARY
REQUEST FOR APPOINTMENT CONSIDERATION
BIOGRAPHICAL INFORMATION FORM

Black Bass Advisory Committee of the Sport Fisheries Advisory Commission. Form updated August 17, 2023.

Instructions: Type or print completely. Send printed or digital copy to: Joseph Love, Program Manager, 580 Taylor Avenue, B-2, Annapolis, Maryland 21401; Phone: (410) 260-8257; Fax: (410) 260-8287; Email: joseph.love@maryland.gov


Application For:

__New Appointment

__Reappointment

Name:


Date of Birth:


DNRid (if in possession): 

Residence

___Resident of Maryland          ___Non-Resident of Maryland                    

If you are a Non-Resident, Why are you applying to a Maryland Committee?


Home Address:


City:


State:


Zip:


Occupation:


Employer:


Office/Home Phone:  


Mobile Phone: 


Email Address:


Representing Organizations (If Any):


Please Check Any That Apply:
___I have targeted black bass within the past 3 years in Maryland
___I am a Maryland licensed black bass guide or have been a black bass guide within the past 3 years
___I have fished a black bass tournament in the past 3 years
___I have served as a black bass tournament director in the past 3 years
___I regularly participate in an organization that promotes or advances conservation in the sport of black bass fishing
___I manage a social media platform or regularly publish (at least once a month) information regarding black bass fishing in Maryland



REQUEST FOR APPOINTMENT CONSIDERATION
BIOGRAPHICAL INFORMATION FORM
OFFICE OF THE SECRETARY

Please Use the Allowed Space BELOW to Comment on:

1) Your experience and time fishing or participating in the black bass fishery in Maryland;
2) The reason(s) you would like to join the Black Bass Advisory Committee; 
3) Your ability to extend information to others within the black bass fishing community in Maryland; and/or
4) An example of how you have worked with others who have different viewpoints or interests to achieve consensus and complete a task.












List the names and contact information for individuals who are familiar with your professional qualifications.





I certify that, to the best of my knowledge and belief, all the information contained in and attached to this questionnaire is true, correct and complete. I understand and agree that I am required to notify the Director of Fisheries Service in writing if any of the information contained in or attached to this questionnaire changes.


Signature of applicant: 

__________________________________________________   

Date: ____________________
(Electronic or typed Signature permitted when application submitted from email account noted on application)


Completed forms may be returned to: 
Joseph Love, Program Manager, 580 Taylor Avenue, B-2, Annapolis, Maryland 21401
Phone: (410) 260-8257        Fax: (410) 260-8287
Email: joseph.love@maryland.gov