Equity and Mobility Advisory Committee Application Question Title * 1. Full Name * Question Title * 2. Organization/Affiliation (if applicable) Question Title * 3. Email Question Title * 4. Phone Number * Question Title * 5. Mailing Address Question Title * 6. If selected to participate as an EMAC member would you request compensation to participate in the committee? * Yes No Prefer not to answer Question Title * 7. Please read the following commitments before answering this question. If selected to participate as an EMAC member, I will commit to: Notifying the EMAC facilitator in advance of any meeting I cannot attend. I understand that irregular attendance will warrant replacement. Alternates are not allowed. Coming to meetings prepared to discuss agenda topics and actively participate in discussions, including providing feedback based on expertise and knowledge. Working collaboratively, actively and respectfully listening to and considering other points of view and interests and being open to new ideas. Serving as a conduit for information to and from affiliated organizations and community members and ensuring that issues, concerns, or needs are raised during meetings. I agree to the EMAC member commitments above. Question Title * 8. Do you represent a statewide organization? * Yes No Question Title * 9. Please tell us why you are interested in participating on this Equity and Mobility Advisory Committee (250 words or less). Question Title * 10. Please explain your commitment to and experience in supporting or advocating for equitable processes and outcomes. Experience can be from your involvement in school, work, community organizations, faith-based organizations, your neighborhood, etc (250 words or less). Question Title * 11. Please describe your experience with the transportation system in the Portland Metro Region. Please tell us if you have specific experience in the Interstate 205 and/or Interstate 5 corridors (250 words or less). Question Title * 12. When would be the best time of day for you to attend EMAC meetings during weekdays? * Question Title * 13. How do you travel most of the time? (select all that apply) Public Transportation Bike Walk Car Other (please specify) Question Title * 14. Race/ethnicity (select all that apply): African African American/Black American Indian or Alaska Native Asian Hispanic/Latino(a)/Latinx Middle Eastern Native Hawaiian or Pacific Islander Slavic White/Caucasian Prefer not to answer Other (please specify) Question Title * 15. Gender Female Non-binary or gender non-conforming Male Prefer not to answer Prefer to self-describe Question Title * 16. Age 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 or older Prefer not to answer Question Title * 17. Annual Household Income Less than $24,999 $25,000 to $49,999 $50,000 to $89,999 $90,000 to $119,999 $120,000 or more Prefer not to answer Done