Keizer Oregon Official Website - Youth Committee Liaison Application Form

Youth Committee Liaison Application Form

Each school year a Youth Liaison may be appointed as a non-voting member to any City Board, Committee, or Commission. To receive this appointment the candidate must be a Keizer resident who is either attending high school or a registered home schooled student. The appointment shall be by majority vote of the Councilors present, following a recommendation from the Volunteer Coordinating Committee.

Youth Committee Liaison

Will be open to all age groups.
Will attend committee meetings of the group for which they are liaison.
Will share information from committee meetings with the Youth Council.
Will be urged to recruit candidates to fill their position near the end of the school year.

*First and Last Name

*Phone

*Address

*City, State and Zip Code

*Email Address

*Please write a brief narrative describing your interest, qualifications and what you hope to accomplish in this position. Include your skills, experience, and knowledge that you would contribute to this volunteer position. (Feel free to attach a cover letter, resume, or other helpful information.)

*Personal Reference

Previous Volunteer Experience: Name & Address of Volunteer Agency and your duties

*I understand that I will be required to attend scheduled committee/commission meetings. All meetings meet at 6:00 p.m. Select committee preference.

Arts Commission (3rd Tuesday, Bi-Monthly)

Parks Advisory Board (2nd Tuesday, Monthly)

Traffic Safety/Bikeways (3rd Thursday, Monthly)

Planning Commission (2nd Wednesday, Monthly)

*I understand the time commitment and duties involved for the position I am seeking.

*AUTHORIZATION WAIVER: I have completed the above questions and to the best of my knowledge, what has been stated is true. If appointed to a volunteer position, I agree to serve without reimbursement of any kind and with the understanding and agreement that medical insurance is not provided by the City of Keizer. Volunteers for the City of Keizer are covered under the city’s liability insurance and workers compensation program. As a volunteer applicant, I understand that I may be subject to a criminal records check. I further understand that irrespective of any criminal records check, the City of Keizer may decline my volunteer application or volunteer services at any time. Please type your signature below.

Typed name will be considered a signature

Signature of Parent/Guardian

Typed name will be considered a signature

Reference Letter (Optional)

Resume (Optional)

Confirm

Cancel

City of Keizer, Oregon

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City Hall
930 Chemawa Rd NE
Keizer, OR 97303
Phone (503) 390-3700

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