S:\Manager's Office\FORMS\Commission Forms\2020\03-04-2020 Boards and Commissions Application.docx
Application for Boards, Advisory Commissions and Committees
Name: ____
Street Address: Mailing Address:
Preferred Phone Number: Alternate Number:
Email Address:
City Resident? Yes No City Employee? Yes No
Have you previously served on any of the City’s Boards/Advisory Commissions/Committees? Yes No
If yes, which one(s) and when?
Applications will be retained for 90 days, after which you will need to complete a new application for consideration to fill a vacancy.
Applying for: Please indicate your preferences by putting a number in the box next to those on which you would like to serve~~1
for your first choice, 2 for your second, etc.,you may serve on two (2) plus the Budget Committee.
On how many Commissions, other than the Budget Committee, do you wish to serve? One Two
Air Quality
Budget Committee
Building Board of
Landscape and
Parking, Traffic
Safety, and
Parks and
The following Advisory Commissions have specific requirements and expectations. Please initial on the line in
front of the Advisory Commission for which you are applying to indicate that you meet and agree to these
requirements and expectations.
________ Landmarks Members appointed to the Landmarks Advisory Commission shall have a demonstrated
interest, competence, or knowledge of historic preservation. At least three (3) members should be professionals
from the disciplines of history, archaeology, planning, law, architecture or architectural history. An individual appointed to
the Landmarks Advisory Commission shall be resident of the City or a property owner within the Historic District of the
City of La Grande, Oregon; except that two (2) such members may be residents of Union County.
_______ Library Chapter 357 of Oregon Revised Statutes requires that a public library be governed by a Library
Advisory Commission. Commission members shall be individuals who are actively interested in Library services
and programs, and in all instances, serve as advocates for the Cook Memorial Library, its services and programs.
The five (5) Commissioners shall serve four-year (4-year) terms.
_______ Planning Members of the Planning Commission are required to complete an annual Statement of
Economic Interest, to be submitted to the Oregon Government Ethics Commission. ORS 227.020 provides the
authority for the creation of a Planning Commission. The Commission renders final decisions in connection with certain
land use procedures, unless appealed to the City Council. All five (5) members of the Commission shall reside within the
Urban Growth Boundary, but only one (1) may reside outside the City limits. A member of the Planning Commission
may serve no more than two (2) consecutive terms, but may again be considered for appointment after one (1)
year of nonparticipation on the Commission.
_______ Union County Tourism Advisory Committee City appointed members to this Advisory Committee shall
be either the owner or manager of a large lodging property in La Grande, or the owner or manager of a La Grande
retail business or restaurant.
S:\Manager's Office\FORMS\Commission Forms\2020\03-04-2020 Boards and Commissions Application.docx
_______ Urban Renewal Advisory Committee (URAC) An individual appointed to the Urban Renewal Advisory
Commission shall be actively interested in curing and preventing conditions of blight and improving the physical,
economic and social conditions within the Urban Renewal District. Members shall be residents of La Grande; or the
owner of real property or a business located in the Urban Renewal District; or an elected official or highest appointed official
of a taxing jurisdiction impacted by Urban Renewal. Additionally, two Commissioners must own or manage a business
(though it does not need to be located in the Urban Renewal District)
For URAC ONLY: Do you: Own a property(ies) or business(es) in the La Grande Urban Renewal District?
Yes No
If yes: Name of business: Address:
Do you: Own or manage a business(es)?
Yes No
If yes: Name of business: Address:
Are you an elected official or highest appointed official of a taxing jurisdiction impacted by Urban Renewal?
Yes No
If yes: Name of Jurisdiction: Position:
Please indicate why you are volunteering and what makes you a good candidate to serve. Please include any special
training, experience, education, and/or qualifications you may have that are unique or specific to the Advisory
Commission/Committee for which you are applying. (Please attach no more than one additional typewritten page).
PLEASE RETURN YOUR COMPLETED APPLICATION TO: Stacey Stockhoff, Assistant to the City Manager, or
Kayla Rock, City Recorder; 1000 Adams Avenue/P. O. Box 670; FAX (541) 963-3333
Pursuant to City of La Grande Ordinance, applicants for Boards and Advisory Commissions/Committees may be
subject to a background review. Please complete the following Release for Background Check. This information
is for office use only and not subject to public disclosure.
Name: Date of Birth:
Mailing/Street: Social Security #: ________________________
Signature _______________________________________________ Date:
For Office Use Only
Criminal Background search completed by: on
___ Eligible for Hire ___ Further investigation recommended
(negative) (positive)
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