Measure I Citizens’ Bond Oversight Committee Membership Application

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

I would like to represent the following constituency in the District: (please check all that apply)*

Active in Organization Supportive of the College, such as Advisory Council or FoundationAt-Large Community Member – Resident of the Redwoods District Community College DistrictBusiness Representative - Active in a business organization representing local businessSenior Citizen Group Representative - Active member in a senior citizens’ organizationStudent enrolled in College of the Redwoods and active in a community college support group, such as student government.Taxpayer Organization Member – Active in a bona fide taxpayers’ association

If you selected an affiliation with an association, organization, business, or foundation above, please note the name of the entity.

Do you have any special area of expertise or experience that you think would be helpful to the committee?*

If you have served on other school district, college, or city or community committees please list and briefly describe your role:*

Please note any additional information you feel should be considered as part of your application*

Are you an employee of the College? *

YesNo

*(Employees, vendors, contractors, and consultants of the Redwoods Community College District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.)

Are you a vendor, contractor, or consultant to the school district?*

YesNo

Do you have conflicts that would preclude your attending quarterly meetings?*

YesNo

Do you know any reason such as a potential conflict of interest, which would adversely affect your ability to serve on the Citizen’s Oversight Committee?*

YesNo

*(Employees, vendors, contractors, and consultants of the Redwoods Community College District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.)

If yes, please list the potential conflicts of interest.