2019 #ClackCo Academy Application

#ClackCo Academy is a free course that gives members of the community the opportunity to learn more about county services and programs. Participants get a unique look at how Clackamas County functions by hearing presentations/panels from staff, participating in group discussions, and touring county facilities.

Applicants of the #ClackCo Academy must live, own a business, or work full-time in Clackamas County. Space is limited to 25 participants, with an additional 5 seats reserved for youth ages 16-20. Clackamas County strives to achieve a diverse group of participants based on many demographic factors, such as geography, employment status, age, and other factors.

Participants will be selected and notified by March 22. Those selected are strongly encouraged to attend all classes in order to fully benefit from the program. If you are unable to commit to at least five of the dates, please do not apply at this time.

For more information, please contact Katie Wilson at 503-742-655-8552 or kwilson2@clackamas.us.

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* 1. Please fill out each field below.

Name

Street Address

City

Phone

Occupation

Pronouns (example: he/she/theirs)

Native language

How did you hear about #ClackCo Academy?

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* 2. To be considered, applicants must be one of the following (please check all that apply):

Resident of Clackamas County

Owner of a business located within Clackamas County

Employed full-time within Clackamas County

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* 3. Why do you want to participate in the #ClackCo Academy?

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* 4. Have you had any prior experience with Clackamas County, such as serving on a board, commission or other similar entity? If so, please list:

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* 5. Do you need any special accommodations to participate? If so, please list such. Note: We want to be prepared and inclusive. This will not affect your chances of being selected.

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* 6. Will you be able to attend at least five of six monthly classes, held once a month on Wednesday evenings for two-to-three hours?

Yes

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* 7. I acknowledge that video and photography may be taken during the academy and used in county promotions.

Yes, I acknowledge that videos or photos may be taken during this program.

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* 8. What is your age? (optional)

16 - 20

21-40

41-65

66+

I decline to answer

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* 9. Are you Hispanic or Latino? (optional)

Yes, I am Hispanic or Latino

No, I am NOT Hispanic or Latino

I decline to answer

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* 10. What is your race? Select one or more. (optional)

American Indian or Alaska Native

Asian

Black or African American

Native American or Pacific Islander

White

I decline to answer

Thank you for your interest in the #ClackCo Academy! Participants will be selected and notified on or before March 22.