Water Academy Application

Application
JXN Water invites the community to apply for the Water Academy through this open application process.

The JXN Water Academy is a great opportunity to learn the business of running a professional, reliable water and sewer system.

Applications are currently being taken for the fall cohort.
Guidelines
- I understand that this is voluntary and non-compensated.
- I will attend each meeting (or as otherwise scheduled), during the term of the Water Academy (as determined by JXN Water).
- I will commit my time to this Water Academy as necessary, which includes three Saturday sessions and then an estimated 1-2 hours a week.
- If selected, I understand that I will need to provide additional information required by JXN Water to conduct a background check.
Who You Are
First Name
Last Name
Date of Birth
Email*
Telephone Number*
Neighborhood*
Street Address*
Zip Code*
Are you served by JXN Water?

YesNo
Do you own property in Jackson?

YesNo
Do you currently have a JXN Water account?

YesNo
Are you currently up to date on your bill?

YesNo
Note: Your address will be used to verify residency.
Diversity, Equity, and Inclusion
JXN Water aspires for the Water Academy to reflect the diversity of the community, especially those individuals close to where JXN Water projects are located. Please share details about your background to help our reporting purposes.
Age
Disabled

YesNo
Ethnicity
Gender
Primary Language Spoken
Race
Veteran

YesNo
Describe which component of JXN Water projects or processes in which you are most interested in:
Affiliations
Are you affiliated with any of the following types of organizations? Please select all:

1st Responder/Emergency ServicesAcademic (Higher Education, Secondary/Elementary Education)BusinessCivicDevelopment CommunityEnvironmentalFaith-Based OrganizationMedical or Healthcare OrganizationNon-profit OrganizationRestaurant Owner or Hospitality CommunityVulnerable PopulationOtherN/A
Members of the Water Academy are expected to represent a broad range of stakeholders locally. Please note that being affiliated with an organization is not mandatory to be a Water Academy member.
If affiliated with any of the above types of organizations, please specify the name of the organization, your position, and the years you served:
Please expand on one or two of your affiliations above that is the most significant to you, or will serve you best, in your position with the Water Academy:
Why are you interested in participating in the Water Academy? What insights are you looking to gain from the experience?
Statement on Conflicts of Interest
We kindly ask all applicants to disclose all conflicts of interests that may give the appearance of impropriety, should you be chosen to sit on the JXN Water Academy (e.g. if you are a contractor that would stand to gain financially from sitting on this Committee).

Please note that you are not necessarily prohibited from sitting on the Water Academy if you have a conflict of interest. We will evaluate each application on a case-by-case basis to make a final determination. Should you be selected as a member of the Water Academy, we may request additional information regarding your conflict(s) of interest. If you have any further questions regarding conflicts of interest, please email tiana@jxnwater.com.
Signature
Should be Empty:

Application

Guidelines

Who You Are

Diversity, Equity, and Inclusion

Statement on Conflicts of Interest