Inclusivity Committee Application

Committee or Commission of Interest *

Name *

Phone Number *

Residence Address *

Mailing address (if different)

Best contact phone number

Best contact email address

Have you attended the Philomath Citizens' Academy? Yes
No

Please explain why you would like to serve on this Committee

What do you believe the primary goal(s) of this Committee should be?

Please describe any interest or experience you have with justice, equity, diversity and inclusion and what they mean to you. (Lack of experience will not disqualify your application from consideration.)

City of Philomath Committees
and Diversity, Equity, and Inclusion

The City of Philomath values diverse perspectives, backgrounds, and life experiences. We encourage individuals from all backgrounds and communities to apply for openings on our boards and committees to help shape Philomath's future.

* - denotes required field