Communities of Opportunity Governance Group (GG) / Advisory Board application
Thank you for your interest in serving on the Communities of Opportunity (COO) Governance Group! Individuals selected to serve will be required to submit a statement of Financial Interest and Code of Conduct form and may also be required to complete a King County Ethics Program Financial Disclosure Form within two weeks of being nominated to serve.  

PLEASE NOTE:  Information provided on this form will be a public record subject to free and open examination by any person under the Washington State Public Records Act (RCW 42.56.250).  However, while we will disclose the applicant’s name, the applicant’s address, phone number and email address will be redacted.

Application instructions may be found here: https://www.coopartnerships.org/blog/2021/11/29/communities-of-opportunity-is-seeking-new-governance-group-members

Applications submitted will be considered on a roling basis. 

Questions? Email info@coopartnerships.org 
Sign in to Google to save your progress. Learn more
Name (First, Middle Initial, Last) *
Phone Number *
Email address *
Preferred Mailing Address (including City, State & Zip Code) *
Physical Home Address (including City, State & Zip Code). REQUIRED if different from preferred mailing address.
King County Council District of  residence (You can find your district here: https://kingcounty.gov/depts/elections/elections/maps/find-my-districts.aspx) *
Job Title & Current Employer *
Employment Address (Including City, State, Zip Code) *
How did you learn of this opportunity?
Composition of COO Board
The Governance Group includes representatives from COO-funded partner organizations.  These questions help us meet membership requirements of COO by King County Ordinance.

For reference, COO funded partners are compiled here: https://www.coopartnerships.org/partners 
Are you a member of a COO funded Place-Based or Cultural Community Partnership? If so, please indicate which partnership: *
Is your organization a current grantee of COO's Systems & Policy Change strategy? *
If yes, what organization:
Is your organization a current grantee of COO's Learning Community strategy? *
If yes, what organization:
Composition of COO Board
The COO Governance Group composition is designed to reflect the diversity in King County as well as specific experiences, knowledge, and expertise related to the initiative’s goals for greater racial, social, economic, and health equity.

If you are interested in being considered to be a representative for a specific community or sector, please indicate below the board membership position(s) of interest to you.

This information will help us meet membership requirements of King County Ordinance.
Please check which Board positions are applicable and of interest below: *
Required
Prior Board/Committee Experience. Have you served on any other Board, Commission or Committees? (Please list them here, along with the year of appointment, and term expiration)
References (Name, Email Address or Phone Number, and their relationship to you). Please list two people who COO can contact who are familiar with your background/experience working with communities on issues such as equitable community development, affordable housing, health, economic prosperity, community and civic engagement, community power building, and racial equity and social justice. *
Application Questions
Please provide answers to each of the 4 narrative questions below.  
Why you are interested in participating on the Governance Group – and what is your vision and hope for Communities of Opportunity over the next five years? *
Tell us how your background has shaped how you approach building equity? *
Tell us about your experience as a community leader with: 1) Community health and well-being, affordable housing, community development, economic opportunity, and/or community connection and civic engagement? 2) Racial equity and social justice issues?3) Organizing, advocacy, and community power-building? *
Anything else that you would like us to know about your interest in serving on the COO Governance Group? *
Personal Information (optional)
The King County Council and the King County Executive are committed to inclusiveness and outreach to all King County residents to ensure that King County boards and commissions are reflective of the community we serve. Providing information in the section below is voluntary but will assist in achieving this goal.
How do you identify?
Race/Ethnicity
Gender
Orientation
Personal Pronouns (he/him; she/her; they/them; etc.)
Do you have a disability as defined by the Americans with Disabilities Act?
Clear selection
Generation Range (age range)
Clear selection
Agreement and Signature (required)
Applications are currently considered on a rolling basis. If you need the application in alternate formats, or if you have questions about the application, please contact: info@coopartnerships.org. 
By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge. Please date and sign your application:
Signature (please type your name): *
Date of Submission *
MM
/
DD
/
YYYY
Thank you! We will follow-up with all applicants by the end of February.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Communities of Opportunity. Report Abuse
Google Forms