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2. First Name*
3. Last Name*
5. Address*
7. Address
9. City*
10. State*
11. Zip*
13. Home / Cell Phone*
14. Work Phone
16. Email*
18. On which commission / advisory board are you asking to serve?*

    The following list is a comprehensive listing of all Linn County volunteer advisory boards and commissions which may or may not have current vacancies. Vacancies are noted on the individual advisory board or commission webpage. 

    1. Americans with Disabilities Act (ADA)
    2. Board of Adjustment
    3. Board of Health
    4. Building Board of Appeals
    5. Child Development Center Advisory Committee
    6. Community Services Advisory Board
    7. Compensation Board
    8. Compensation Commission on Condemnation
    9. Conservation Board
    10. Electrical Board of Appeals
    11. Fire Districts and Officers
    12. Food Systems Council
    13. General Assistance Advisory Committee
    14. Historic Preservation Commission
    15. Judicial Magistrate Nominating Commission
    16. LIFTS Transportation Advisory Committee
    17. Mechanical Board of Appeals
    18. Options Advisory Committee
    19. Planning and Zoning Commission
    20. Plumbing Board of Appeals
    21. Public Art Commission
    22. Roadside Advisory Committee
    23. Ryan White Home Health Advisory Committee
    24. Sustainability & Resiliency Advisory Committee
    25. Veteran Affairs Commission
    26. Water and Land Legacy Bond Public Review Board
    27. Watershed Management Authorities (WMA)
20. How did you hear about this opportunity?*

    1. Linn County Email
    2. Linn County Website
    3. Newspaper
    4. Social Media
    5. TV
    6. Word of Mouth
    7. I Don't Remember
    8. Other
22. Please tell us how you learned about this opportunity.
24. What topic are you specifically excited about related to sustainability?*
26. When you think about sustainability and the environment, what comes to mind and why?*
28. What are some examples of past experience that make you qualified to be on this committee?*
30. Write a statement of intent about qualifications and experience you could bring to this committee.*
32. What interested you about potentially being on this committee? (Select all that apply.)*

    1. Personal interest in the environment
    2. Linn County's commitment to sustainability
    3. Climate action and greenhouse gas emmissions
    4. Other
34. Please explain choice of "other."*
36. What sustainable actions do you take on a daily basis?*
38. How would serving on the Sustainability & Resiliency Advisory Committee help you with your personal and sustainability goals?*
40. What interests you the most about the possibility of serving on the Sustainability & Resiliency Advisory Committee? (Select all that apply.)*

    1. Data collection and connecting with local utilities
    2. Generating reports
    3. Analyzing and compiling data
    4. Learning more about the greenhouse gas inventory process
    5. Other
42. Please explain choice of "other."*
44. Have you heard about the Linn County Greenhouse Gas Inventory report?*

    1. Yes
    2. No
46. Have you read the report?*

    1. Yes
    2. No
    3. Just the Executive Summary
    4. Other
48. Please explain choice of "other."*
50. How would you define sustainability and climate action?*
52. In your opinion, what do you think are the biggest challenges for the next 10 years related to sustainability and climate action?*

    1. Rising greenhouse gas emmissions
    2. Increase of droughts and heatwaves
    3. Water quality/scarcity
    4. Sea level rise
    5. Flood events
    6. Other
54. Please explain choice of "other."*
56. When thinking of sustainability and climate action, what local actions do you think are most important to take?*
58. How would you describe yourself?*

    1. American Indian or Alaska Native
    2. Asian
    3. Black or African American
    4. Native Hawaiian or other Pacific Islander
    5. White
    6. Middle Eastern and White
    7. Latino/a/x
    8. Other
    9. Prefer not to answer
60. Do you belong to any of the following groups?*

    1. Immigrant
    2. Refugee
    3. People of Color
    4. Senior
    5. Disabled
    6. Rural
    7. Farmer
    8. Prefer not to answer
62. Please list any education, training, or experience you feel is relevant to the appointment you seek.*
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66. 1. Receive an email copy of this form.
67. Email address

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