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 for your records.

You may request to submit a Word version of the application. Email AdvisoryBodies@portlandoregon.gov to request a Word version. All entries must be submitted to Advisorybodies@portlandoregon.gov to qualify. Applications sent directly to the staff liaison will not be counted.

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 AdvisoryBodies@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.
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 advisorybodies@portlandoregon.gov, use City TTY 503-823-6868, or Oregon Relay Service: 711.

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* 1. What is the name of the advisory body you applied to serve on?

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* 2. How did you hear about this opportunity?

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

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* 4. What are your gender pronouns? (Example: she/her, he/him, they/them)

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* 5. Applicant email (so we can contact you about the selection process)

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* 6. Your daytime phone number (so we can contact you about the selection process)

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

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* 8. Are you interested in being contacted about other advisory body opportunities if you are not selected for this one?

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This is a preview of what is to come. For the next sections, be prepared to answer the following questions listed below. You may want to compose your answers in a Word document first, to protect your submission should something go wrong.

For definitions and examples, please visit: https://www.portlandoregon.gov/civic/article/725028.
1. 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. If no, enter "no" or "N/A."

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. 

 2. 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."

3. 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 contract. If no, enter "no" or "N/A."

- 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.

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)

OPTIONAL: 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) ?

OPTIONAL: attach resume, please title and save your file with your name: "First.Last"

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

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

Q1. 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.

Q2. What excites you about the possibility of serving on this advisory body?

Q3. If selected and appointed to serve, what would you hope to accomplish during your service?

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.

Q4) 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.

Q5) Please describe your ability to listen and consider other perspectives which may be different from your own.

Q6) 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.