Boards, commissions and councils application form

If you have any questions, please email [email protected]

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 page here 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.

How did you hear about this vacancy

By visiting www.johnsoncountyiowa.gov

Radio/newspaper/online news media

Other

If you checked Other above, please describe

First Name

Middle Name

Last Name

Suffix

Address

Address 2

City/Town

ZIP/Postal Code

Telephone

(this will be available to the public on the County webpage)

Identify as which gender

Email Address

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?

Yes

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

How much time you will be willing to devote to this board/commission

Your reason for applying

Contributions you can make to this board/commission

In lieu of/in addition to the above, what comments can you add that may assist the Board of Supervisors in its selection

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.”

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