Board/Committee/Commission Application

Type of Phone:
Preferred method of contact:
Please choose the Board, Commission, or Committee(s) on which you are interested in serving: *
Are you applying for reappointment? *
Do you live within the city limits of Sweet Home? *
If no, do you live within the Sweet Home School District boundaries?
By typing my name, I certify that I currently reside within the corporate limits of the City of Sweet Home and am an eligible elector as defined by ORS 246.012(5). I further acknowledge that should either my residency or my eligibility as an elector change I will notify the City of Sweet Home immediately.
CRIMINAL HISTORY BACKGROUND CHECK (CHC):
A Criminal History Check (CHC) may be performed as part of the City of Sweet Home appointment process for City Boards, Committees, and Commissions. I acknowledge that a refusal to allow the CHC to be performed, when required, will cause my application to no longer be considered.
PUBLIC DISCLOSURE:
The City sometimes receives requests for contact information for members serving on City boards, commissions and committees. As an appointed public body volunteer serving the City of Sweet Home, the information provided on this application is considered public record.
I hereby declare that the responses to questions on this form are true to the best of my knowledge and I understand that a CCH may be performed, when required, and that the information provided on this application is considered public record. By typing my full name below, I am electronically signing my application.
Date of Signature
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