Community Involvement Committee Application

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The purpose of this form is to obtain information for use in making appointments to the Multnomah County Community Involvement Committee. Please note that information provided in this document is public information - personal information will be held in confidence as allowed by law.

If you have questions or would like to connect with staff in the Office of Community Involvement, please contact us at 503-988-3450 or send an email to community.involvement@multco.us.

Applications must be received no later than Friday, March 15th 2024 at 11:59pm.

About You

First Name

Last Name

Pronouns

Pronoun Other

Phone

Mailing Address

Mailing City

Mailing State

Mailing Zip

Which Multnomah County District do you reside in:
https://www.multco.us/multnomah-county/find-your-multnomah-county-district

Occupation

If applicable

Employer

If Applicable

Volunteer History & Interest

Have you served on any other Multnomah County boards, commissions, or committees?

Please list them here, including the name of the group, the year you were appointed, and the year your term ended.

Please state any potential conflicts of interest you may have related to any county department, if applicable

Eg. If you are an employee or a board member for an organization that receives county funding and/or has contracts with the County. (Conflicts do not impact your eligibility to serve on the committee, but should be disclosed to ensure compliance with state ethics laws.)

If selected, I am willing and able to follow the CIC Policies and Procedures and participate in and agree to Community Agreements established by the CIC.

YesNo

Why are you interested in joining the Community Involvement Committee? What perspective, experience, or skills do you hope to bring to the group?

Describe a time you were part of a group working towards a common goal. What were your contributions and how did you grow with that experience? What has been difficult for you when working in groups where including all voices, working together across differences, and equity are critical values? How have you addressed those challenges?

The Community Involvement Committee is committed to reducing barriers to participation for communities that have been typically underrepresented in the County decision-making. Describe your experiences with local historically marginalized and underrepresented communities

In your opinion, what are the top 3 barriers to civic participation and community involvement in county decision-making?

Please provide us with a summary of your work and volunteer experience

You may provide a written response or submit a resume. If you wish to submit a formatted resume, you may attach it below

Optional File Attachment

How did you learn about this opportunity?

Is there anything else you'd like us to know?

Optional Questions

The following questions are optional and are used by the Office of Community Involvement to track the effectiveness of our outreach efforts.

What is your age:

Your Gender

Gender Other:

Your Race/Ethnicity

Race/Ethnicity Other:

Household Size (people who live with you):

Approximate Household Income (per year):

What best describes your current housing?

Other Housing:

Do you Rent or Own?

RentOwnOther/Decline to Answer

Sign up for the Office of Community Involvement email list to receive updates about new volunteer opportunities on advisory boards & committees

Yes, please sign me up!

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Contact Information