BOARDS, COMMISSIONS, AND COUNCILS JC Logo - Brown

IN JOHNSON COUNTY, IOWA – APPLICATION FORM

  If you have any questions, please email applications@co.johnson.ia.us

 HOW DID YOU HEAR ABOUT THIS VACANCY? (CHECK ALL THAT APPLY)

          

If you checked Other above, please describe:

* This is a required field.

* First Name:       
* Last  Name:      
* Street Address: 
* City:                  
   State:                 IOWA
* Zip Code:            
* Phone Number:  (this will be available to the public on the County webpage)
* Identify as which gender (check one):      
* Email Address:    

 
1.* Which board, commission, or council are you applying for?  Please be specific by using the full name of the intended group.  You may apply to more than one; however, please complete a separate application for each.

* Have you attended any meetings of the board/commission to which you wish appointment?  

2.* Place of employment, skills, training, experiences, and/or activities (such as hobbies, volunteer work, etc.) that may qualify you for this position and enhance your contributions to the group.

 
3. How much time you will be willing to devote to this board/commission:    
 
 
4. Your reason for applying:
 

5. Contributions you can make to this board/commission:
 
 
6. In lieu of/in addition to the above, what comments can you add that may assist the Board of Supervisors in its selection?
 
 
7.  CONFLICTS OF INTEREST:   Please identify any potential conflicts between your service on this board/commission and your personal interests, including financial interests and duties to an employer.  Iowa Code Section 331.342 states “an officer or employee of a county shall not have an interest, direct or indirect, in a contract with that county.” 


 

Gender balance:  Iowa Code Section 69.16A requires gender balance on County boards and commissions required or governed by state law, unless the County has made a good faith effort for a minimum of three months to appoint a qualified person. The Johnson County Board of Supervisors extends this requirement to apply to all appointees of the Board of Supervisors regardless of whether the board or commission is required by state law.

 

Eligible Elector: Some boards and commissions require you to be an “eligible elector,” defined in Iowa Code Section 39.3 as “a person who possesses all of the qualifications necessary to entitle the person to be registered to vote [in Johnson County], whether or not the person is in fact so registered.” Please refer to the vacancy press release at http://www.johnson-county.com/vacancies to confirm whether appointees are required to possess eligible elector status. If the vacancy press release makes no mention, then this requirement does not apply.

 

When applying, please keep in mind the Johnson County Policy on Attendance on County Boards and Commissions: : “The Board considers regular attendance at meetings an integral part of one’s service on a Board or Commission. While it is not uncommon for someone to miss an occasional meeting, absences should be avoided as they can impair the work done by the Board or Commission on behalf of the public. Additionally, prolonged absences may be grounds for removal from the Board or Commission under the Iowa Code.”

 

YOUR APPLICATION WILL BE RETAINED IN OUR FILES FOR ONE YEAR. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC.

THANK YOU FOR COMPLETING THIS APPLICATION FORM AND FOR YOUR INTEREST IN VOLUNTEERING.

913 SOUTH DUBUQUE STREET ♦ IOWA CITY, IA 52240 ♦ 319.356.6000 PHONE ♦ 319.356.6036 FAX
www.JOHNSON-COUNTY.comjohnsoncountyia.iqm2.com