Application for City Boards, Commissions & Committees
Page 2 of 2
RESIDENCY:
The following applies for appointments that require residency and elector status:
I, ,certify that I currently reside within the
corporate limits of the City of Sweet Home and am an eligible elector as defined by ORS
246.012(5). I further acknowledge that should either my residency or my eligibility as an elector
change I will notify the City of Sweet Home immediately.
CRIMINAL HISTORY BACKGROUND CHECK (CCH):
A Criminal History Check (CCH) may be performed as part of the City of Sweet Home
appointment process for City Boards, Committees, and Commissions. I acknowledge that a
refusal to allow the CCH to be performed, when required, will cause my application to no
longer be considered.
PUBLIC DISCLOSURE:
The City sometimes receives requests for contact information for members serving on City
boards, commissions and committees. As an appointed public body volunteer serving the City
of Sweet Home, the information provided on this application is considered public record.
My signature acknowledges that the information I have provided on the application is true and
complete to the best of my knowledge and I understand that a CCH may be performed, when
required, and that the information provided on this application is considered public record.
Signature Date of Signature