OVERVIEW OF WHAT'S AHEAD & INSTRUCTIONS

Thank you for your interest in serving as a member of a City of Portland advisory body.

This online form is designed to collect information from individuals who are interested in serving on a City advisory body. It includes the following sections:
  1. General Information, Application Questions
  2. Conflict of Interest Disclosure
  3. Voluntary Confidential Demographic Information
This form offers the advantage of a digital timestamp and delivery that certifies your submission date. It is the fastest method to get the application into the hands of the selection committee. It is still recommended that you pre-write and save your answers in a separate document first and paste your answers into the form. We also recommend you save a copy for your records.

You may request to submit a Word version of the application. Email Barry.Manning@portlandoregon.gov to request a Word version. 

Information provided in any of these sections is public information, except for the Voluntary Confidential Demographic Information Form. Any information provided under this section will be held confidential, not tied to your name. The City uses demographic information to identify larger patterns so that it may better engage and serve diverse populations.

To apply, please first review information about the advisory body for which you’re applying, as well as the position description, applicant qualifications and expectations, and selection process at https://www.portlandoregon.gov/civic/apply. If you are interested in applying for more than one advisory body, please submit a new application for each one, as each body has a unique set of work and selection process.

If you have questions and/or need assistance in completing this form, please contact the Office of Community & Civic Life by calling 503-823-4519 or by emailing Barry.Manning@portlandoregon.gov.

The City of Portland is committed to diversity and equity and encourages people who are diverse in terms of race, ethnicity, disability, gender identity, sexual orientation, national origin, age, religion, and geographic identification to apply.

ACCOMMODATIONS

In compliance with Civil Rights laws, it is the policy of the City of Portland that no person shall be excluded from participation in, denied the benefits of, or be subjected to discrimination in any City program, service, or activity on the grounds of race, color, national origin, or disability. To help ensure equal access to City programs, services, and activities, the City of Portland reasonably provides: translation and interpretation services, modifications, accommodations, auxiliary aids and services, and alternative format.

For these services, complaints, and additional information, contact the staff contact for the advisory body for which you’re applying (list available at www.portlandoregon.gov/civic/apply. You may also contact the Office of Community & Civic Life at (503) 823-4519 or Barry.Manning@portlandoregon.gov, use City TTY 503-823-6868, or Oregon Relay Service: 711.
CONTACT INFORMATION

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* 1. Applicant name and/or how you would like to be called:

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* 2. Email (so we can contact you about your application and the selection process):

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* 3. Daytime phone number (same reason as above):

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* 4. Name of the advisory body you are applying to serve on:

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* 5. How did you hear about this opportunity?

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* 6. Currently, do you live, work, play, go to school, and/or worship in the City of Portland? (Please mark an “x” in front of all sentences that apply below, so we can know the variety of ways you are involved in Portland)

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* 7. Are you interested in being contact about other advisory body opportunities if you are not selected for this one? (yes or no)

CONFLICT OF INTEREST QUESTIONS

Members of City advisory bodies are public officials

Based on State law ORS 244.020(15), advisory body members are required to disclose conflicts of interest. Under Oregon Revised Statute 244.020(3), an appointee has conflict of interest when participating in an official action which could or would result in a financial benefit or avoidance of detriment to the public official, a relative of the public official, or a business with which either is
associated.

Additionally, Portland City Code Chapter 1.03, Code of Ethics, requires advisory board members to uphold a specific standard of behavior. This language is included as part of this form and will also be provided as part of your training. Public officials also need to observe the Oregon Government Ethics Commission’s "Oregon Government Ethics Law - A Guide for Public Officials", booklet
available at www.oregon.gov/OGEC/Pages/training.aspx.

For definitions and examples, please visit: https://www.portlandoregon.gov/civic/article/725028

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* 8. Are you or is a relative associated with a business, as defined by ORS 244.020(3)(4), that is related to the subject matter to be considered by this advisory body? If yes, please explain.

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* 9. Even if you or a relative’s connection to a business does not rise to the financial thresholds contained in ORS 244.020(3)(4), the City would like to know of any relationship to a business that could benefit financially from the outcome of the matter to be considered by this advisory body.

Do you or a relative have connections that could result in a financial benefit of more than $500 annually? If yes, please explain. If no, enter “no” or “N/A.”

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* 10. Do you or does any relative of yours have a professional affiliation with the City of Portland, either as a staff member or through a contract? Please list their name, their position, your relationship, the bureau/department, and the contract. If no, enter “no” or “N/A.”

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* 11. I affirm that all information contained in this form is true to the best of my knowledge. If at any time following the submission of this form I become aware of any actual or potential conflicts of interest or if the information provided becomes inaccurate or incomplete, promptly notify the staff contact for the City advisory body.

Misstatement of fact or misrepresentation of information may result in your application being disqualified, or future dismissal from the advisory body.

APPLICATION QUESTIONS

Please review information about the advisory body for which you’re applying at http://www.portlandoregon.gov/civic/apply.

Please answer the following universal questions. No more than 250 words per question.

You may also upload an optional PDF or MS Word resume at the bottom of this page.

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* 12. Describe your relevant skills, knowledge, and lived experience as well as any volunteer, work, and/or educational experience that would serve the advisory body’s ability to meet its mission.

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* 13. What excites you about the possibility of serving on this advisory body?

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* 14. If selected and appointed to serve, what would you hope to accomplish during your service?

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* 15. Please tell us about why you are interested in the Montgomery Park to Hollywood Transit and Land Use Development Strategy, including any connections to land use or transportation planning activities, or impacted/affected communities.

The City of Portland seeks to build diverse representation on advisory bodies in terms of race, ethnicity, disability, gender identity, sexual orientation, national origin, age, religion, and geographic identification, as well as advocacy experience, community involvement, volunteerism, occupation, and education.

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* 16. Please describe your experience working in community, diverse groups, or public bodies, and provide examples in which you contributed to productive group processes and collective work in a collaborative, multicultural, and/or multilingual setting.

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* 17. Please describe your ability to listen and consider other perspectives which may be different from your own.

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* 18. Please address your commitment to and experience supporting and/or advancing equitable outcomes. Refer to examples from: your school, work, community, places of faith, family, etc.

INVOLVEMENT
This section is optional.

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* 19. Are you currently, or have you previously been active with a different advisory body? If yes, please provide the Advisory Body name, host bureau/office, and years you were/are active.

Example:
1) Portland Utility Board; Water Bureau/BES; 6/2016 - 11/2016 (left for health reasons); 1/2019 - current.
2) Bureau Budget Committee; BOEC/911 Operations; 2/2014 - 4/2016 (completed full term)

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* 20. Using the same format as above, do you have any groups and associations you would like to share with us (e.g. professional, social, religious, volunteer, advocacy, etc)?

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* 21. If you would like to submit a resume, please insert it here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File
VOLUNTARY CONFIDENTIAL DEMOGRAPHIC INFORMATION FORM
This section is optional.

For Applicant:
Completion of this section is not required and is therefore completely voluntary. The City is committed to diversity, inclusion, and equity and uses the demographic information you provide in the following pages to help ensure that advisory body appointments represent a broad cross-section of community.

This information will not be used during the recruitment or selection process. State and federal law prohibit discrimination against you based on your status in a protected class. This information is not anonymous. The City will treat this information as confidential to the fullest extent allowed by law. This may include sharing demographic information for all advisory body candidate applications with the staff liaisons after the recruitment cycle has ended.

To ensure confidentiality, do not send this information to the staff person who works with this advisory body. Please send your application and confidential demographic information to the general program email for all advisory bodies: AdvisoryBodies@PortlandOregon.gov.

Or mail to:
Advisory Bodies Program
City Hall
1221 SW 4th Avenue, Room 110
Portland, OR 97204

Please continue to the next section by opening the link to the Voluntary Demographic Questions in a new window, then submit this part of the application by clicking Done below.

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