Home > Commissioners > Application for Volunteer Board and Committees Application for Volunteer Board and Committees The Board of Ada County Commissioners wishes to guarantee that their appointments to Ada County committees, commissions, and boards will best serve the public interest of the County as well as be representative of a broad cross-section of the community. We ask you to provide us with the information that will best assist us in evaluating your application. While we appreciate all applicants’ interest and willingness to volunteer, due to potential conflicts of interest, Ada County employees are not permitted to serve on any volunteer board that is overseen by the Ada County Commissioners.Applying For:* (Name of Committee, Commission, or Board)I. PERSONAL INFORMATIONName First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work PhoneHome PhoneEmail Address Place of Employment Work Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you been a resident of Ada County? Do you live within an incorporated city in Ada County? If yes, identify where Field of Study II. EDUCATIONDo you have a high school diploma or high school equivalency (i.e. GED)? Yes No Do you have an undergraduate degree from a college or university? Yes No If yes, please describe Do you have a graduate degree from a college or university? Yes No If yes, please describe Do you have any other specialized training or certifications? Yes No If yes, please describe III. EMPLOYMENT HISTORYPlease provide a brief summary of your employment history for the last ten years, beginning with your current or most recent employer:1. Occupation 1. Employer 1. Dates of Employment (Mo/Yr) 2. Occupation 2. Employer 2. Dates of Employment (Mo/Yr) 3. Occupation 3. Employer 3. Dates of Employment (Mo/Yr) 4. Occupation 4. Employer 4. Dates of Employment (Mo/Yr) IV. EXPERIENCEHave you previously applied for a volunteer committee, commission or board for any city or county agency? Yes No If yes, which one(s)? Have you previously served or are you currently serving on a volunteer committee, commission or board for any city or county agency? Yes No If yes, which one(s)? Have you ever attended a meeting of the volunteer committee, commission or board for which you are applying? Yes No If yes, approximately when did you attend? Please briefly describe your understanding of the responsibilities of the volunteer committee, commission, or board for which you are applying:What particular talents or skills would you bring to the volunteer committee, commission or board for which you are applying?Please describe your involvement in, or affiliation with, any professional associations:V. CONFLICTS OF INTERESTIdaho’s Ethics in Government Act defines a “conflict of interest” as any official action or any decision or recommendation by a person acting in a capacity as a public official, the effect of which would be to the private pecuniary benefit of the person or a member of the person’s household, or a business with which the person or a member of the person’s household is associated. I.C. § 74-403(4) Volunteers appointed to Ada County boards or committees are “public officials” for purposes of conflict of interest analysis. Appointed board or committee members have legal obligations where an actual or apparent conflict of interest exists, and should consult the Ada County Prosecutor’s Office in such circumstances.Have you ever been involved in litigation against Ada County or any of its agencies? Yes No If yes, please explain:Have you ever received an adverse ruling in any matter involving Ada County or any of its agencies (e.g. tax assessment disputes, zoning and planning disputes, etc.)? Yes No If yes, please explain:Please explain any conflicts of interest or potential conflicts of interest not already set forth above that you may have if chosen for an appointment to the volunteer committee, commission or board for which you are applying:VI. MISCELLANEOUSMeetings can be held in morning hours, noon hours, afternoon hours and evening hours. There can be a meeting once a week or more. Are you able to attend meetings during these hours? Why do you wish to be a member of the volunteer committee, commission or board for which you are applying?Have you ever pled guilty to or been convicted of a felony? Yes No If yes, please explain, including date of conviction:Have you ever pled guilty to or been convicted of a misdemeanor? Yes No If yes, please explain, including date of convictionAda County is committed to the implementation of the Americans with Disabilities Act. Are you familiar with this law? Yes No I certify the answers I have made to each and all of the foregoing questions are true to the best of my knowledge and belief. By signing below, I acknowledge that I understand Ada County may use any information submitted with this application to conduct a background check.Date MM slash DD slash YYYY Signature of Applicant By typing your name you verify you have read this form Please note all application materials submitted will become public record once submitted and may be disclosed pursuant to the Idaho Public Records Law, Title 74, Chapter 1 Idaho Code.
