Fort Valley, GA: Volunteer Application

If you are a Fort Valley resident, at least 18 years old, and willing to volunteer your time and expertise to your community, please complete and submit this form. Items marked with a star are required.

Name:*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Daytime Phone:*

Area CodePhone Number

Evening Phone:

Area CodePhone Number

E-mail address:*

Place of Employment:

Job Title:

We ask your help in assuring diversity of membership by age, gender, and race by answering the following questions:

Sex:

Ethnic Background:

Date of Birth:

MonthDayYear

*Please list (in order of preference) the Boards/Commissions on which you would be willing to serve. Select at least one (1):

1.*

2.

3.

Please list work, volunteer and educational experience.

Work Experience:

Volunteer Experience:

Education:

Other Comments:

How did you become aware of Fort Valley volunteer opportunities?

If Other, how?

ETHICS GUIDELINES FOR CITY ADVISORY BOARDS AND COMMISSIONS

By submitting this electronic application, I pledge that, if appointed, I will comply with the following ethics guidelines for advisory boards and commissions.

Members of advisory boards and commissions shall not discuss, advocate, or vote on any matter in which they have a conflict or potential conflict of interest or an interest which reasonably might appear to be in conflict with the concept of fairness in dealing with public business. A conflict of interest or a potential conflict occurs if a member has a separate, private, or monetary interest, either direct or indirect, in any issue or transaction under consideration. Any member who violates this provision may be subject to removal from the board or commission.

If an advisory board or commission member believes he/she has a conflict or potential conflict of interest on a particular issue, then that member should state this belief to the other members of his/her respective advisory board or commission during the board or commission’s public meeting. The member should state the nature of the conflict, detailing that he/she has a separate, private, or monetary interest, either direct or indirect, in the issue or transaction under consideration. The member should then excuse himself/herself from considering and voting on the matter. In cases where an advisory board or commission member declares a conflict or potential conflict of interest, the member shall excuse himself/herself from the board table/voting area until all discussion, consideration, and voting is completed on the matter in question.

Any advisory board or commission member having questions or needing assistance regarding the interpretation of these ethics guidelines or other conflict of interest matters should contact the administrative staff for the respective board or commission. Staff will assist the member with questions and interpretations and may provide a recommendation on whether or not the advisory board or commission member should excuse himself/herself from voting. The member may request that the staff respond in writing. Staff may contact the City Administrator for any additional assistance.

Georgia Public Records Law requires that any information that you provide on this application for volunteer service be available for public inspection.

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