NOMINATING NEIGHBORHOOD ORGANIZATION/ASSOCIATION/AD HOC COMMITTEE INFORMATION

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* 1. Candidate is Interested in representing:

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* 2. If organization is a Public Housing Community, please specify which one.

NOMINEE PROFILE INFORMATION

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* 3. Neighborhood Candidate Contact Information

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* 4. Are you a native of Asheville, North Carolina?

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* 5. Are you a current resident of Asheville, North Carolina?

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* 6. If "Yes," how long have you been a resident of Asheville, North Carolina?

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* 7. If not a current resident of the City of Asheville, are you a current resident of Buncombe County?

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* 8. If "Yes," how long have you been a resident of Buncombe County?

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* 9. What is your relationship with the neighborhood you would like to represent?

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* 10. If you are a current resident or previous resident, how long have you resided or did you reside in the neighborhood?

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* 11. Do you support the City of Asheville's Reparations Resolution?

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* 12. Have you been impacted personally by systemic racism in Asheville?

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* 13. If "Yes," please provide a brief summary of one or more examples

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* 14. If "Yes," In which of the following categories have you been impacted personally by systemic racism in Asheville? (Check ALL that apply)

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* 15. If you have not been impacted by systemic racism personally, please describe your understanding of systemic racism in Asheville, North Carolina

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* 16. Why are you interested in serving on the Community Reparations Commission?

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* 17. List any special knowledge, qualifications, and/or experience in the five impact focus areas (or beyond) you will provide as a member of the Community Reparations Commission

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* 18. What do you hope to achieve by serving on the Community Reparations Commission?

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* 19. What impact focus areas are of the most interest to you? Please rank from 1st to 5th.  If completing this form online, please click and drag in the order of interest.

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* 20. What do you believe your greatest contribution will be in serving on the Community Reparations Commission?

CANDIDATE DEMOGRAPHIC INFORMATION
This information is requested for the sole purpose of assuring that a cross section of the community is appointed.

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* 21. Your Race (Check ALL that apply)

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* 22. Your Gender

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* 23. Your Age

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* 24. What language(s) is/are spoken at your home? Please check all that apply or use "other" to describe.

NOMINEE MEETING PARTICIPATION INFORMATION
Please Note:  Nominees will not be excluded based on their responses to the questions related to meeting participation.  This information will be used for meeting planning purposes to ensure that every nominee has the opportunity to participate fully.

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* 25. Does nominee have equipment and access to the internet to participate in remote meetings?

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* 26. What day(s) work best for nominee to attend meetings on a consistent basis? (Check ALL that apply)

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* 27. What time(s) during the work week work best for nominee to attend meetings on a consistent basis? (Check ALL that apply)

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* 28. What type of support might be helpful to you if a neighborhood group nominates you to serve on the Community Reparations Commission (Check ALL that apply)?

ADDITIONAL COMMENTS

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* 29. Additional Comments:

CERTIFICATION
I certify that I have given true, accurate, and complete information on this form to the best of my knowledge. I agree to serve on the Community Reparations Commission.

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* 30. Signature

COMMUNITY/NEIGHBORHOOD ENDORSEMENTS
Endorsements are not required. However, endorsement information may be helpful to the neighborhood organization reviewers during their selection process.

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* 31. Please list name, phone number, and email address for each of your endorsers:

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