Polk County Boards, Committees & Commissions Application

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Please complete the following online application if you would like to be considered for service on a Polk County Board, Committee or Commission.  Thank you for your interest in serving Polk County and its citizens. Please note that these groups may or may not have openings at any given time.

 

Polk County Board of Commissioners
850 Main Street
Dallas, OR 97338

Email:  Nicole Pineda

ph.: (503) 623-8173
fax: (503) 623-0896
 

___________________________________________________________________________

Personal Information
Resident of Polk County? *
Business Information
Boards, Committees & Commission Information
Please Consider Me for Appointment to the Following Committee(s) *

Certification

By submitting this application, I certify that the answers provided on this form are correct, to the best of my knowledge and belief.

I further certify that I am a registered elector of Polk County, Oregon, as required by Section 8, Article VI, Oregon Constitution.

I agree to attend an orientation for Polk County Boards and Commissions, if I haven't already done so.

I also certify that I have read the Code of Ethics for Public Officials, as set out in ORS 244.040, and that my failure to observe its requirements could result in my removal by the Polk County Board of Commissioners, and might subject me to other penalties under state law. I understand that if I have doubt about a particular situation, I can consult with County Counsel for advice, who will assist me, if necessary, in obtaining a ruling from the Oregon Ethics Commission.
 
I also certify that I have read Polk County Code 20.050, and that my failure to observe its requirements could result in my removal by the Board of Commissioners.

Polk County Board of Commissioners
850 Main Street
Dallas, OR 97338

Email:

ph.: (503) 623-8173
fax: (503) 623-0896

Yes, this is a trick question and easy to answer.
We ask it because spam bots are not smart enough to answer correctly, while humans are.