THIS IS A PUBLIC DOCUMENT: As a candidate for a public board or commission, the information provided will be available to the County Council, County Executive, and the public. All board and commission members are expected to be fair, impartial, and respectful of the public, County staff, and each other. Failure to abide by these expectations may result in revocation of appointment and removal from the appointive position.
Please type in your Mailing Address above
If the name of the board, commission, or committee to which you are applying is not in the above list, enter here.
Per RCW 41.14.030, no two commissioners shall be adherents of the same political party. Please state your political party affiliation, if applicable.
Indicate which position you are applying for:
Please indicate the industry or higher education position you represent:
Please select one of the following that most applies to you:
Do you represent one of the following? If yes, please explain in Question 10: community members from under-represented communities; community action agency, non-profit housing organization or social service agency; faith community; private school, home school, higher education or child care provider; medical and behavioral health care provider serving young children and families; community members with experience caring for children such as parent, foster parent, grandparent, or guardian; private business, corporation, or philanthropic organization.
Indicate which sector you would like to represent:
Indicate which position you are applying for
Please select one of the following that most applies to you. If you indicate that you have relevant professional experience in a field not listed, please explain in question 9:
If applicable, please refer to vacancy list.
(7) "Candidate" means any individual who seeks nomination for election or election to public office. An individual seeks nomination or election when he or she first:
(a) Receives contributions or makes expenditures or reserves space or facilities with intent to promote his or her candidacy for office;
(b) Announces publicly or files for office;
(c) Purchases commercial advertising space or broadcast time to promote his or her candidacy; or
(d) Gives his or her consent to another person to take on behalf of the individual any of the actions in (a) or (c) of this subsection.
List most recent dates first
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Please type in your name.
Physical location of where you are when submitting this form.
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