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Board Application Form

  1. Westmoreland County PA Seal

  2. Thank you for your interest in the Westmoreland County Behavioral Health and Developmental Services Board.

  3. Personal Information

  4. Sex:*

  5. Residency Information

  6. Are you a registered voter?*

  7. Education and Hobbies

  8. Organization Membership Information

  9. Are you currently serving on other Boards, Commissions, or Authorities?*

  10. Have you served on a Westmoreland County Board, Commission, or Committee before?*

  11. How did you hear about this application?

  12. Leave This Blank:

  13. This field is not part of the form submission.