Candidate Application

First Name*

Last Name*

Address

Street Address*

Address Line 2

City*

State/ Province / Region*

Zip Code*

Country*

Phone No.*

Email Address*

I am applying for the Board position in the following District:*

District 1 (San Juan, Brown, Henry, Pearl and Spieden islands)

District 2 (Orcas, Armitage, Big Double, Blakely, Fawn, Little Double and Obstruction islands)

District 3 (Lopez, Decatur, Center and Charles islands)

District 4 (Shaw, Bell, Canoe and Crane islands)

Are you a resident of the district you are applying for where you physically reside and are served by an OPALCO residential service for which you have financial responsibility?*

Yes

Please list any education, training or specialized experience you feel relates to your qualifications to be a Director that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, military training, hobbies, etc.

You may choose to just upload your resume.

List your three references with their contact information here or upload below.*

Please include a brief bio (300 word limit) including your qualifications, experience and platform – what you would bring to the Co-op membership as a board member.*

This bio will appear in the Voters’ Guide. Please review a past Voters’ Guide for examples of how candidates present themselves. Go to the Document Library to find past years guides.

Please upload necessary documents*

Documents to attach include: resume, references, bio, headshot, Director Qualifications Form and Background Check Release. All these can be found on the website. Please use PDF file format for resume, references, and bio. Please ensure the headshot photo meets the print quality requirement of 300 DPI (use JPG or PDF file format). Make sure the Director Candidate Disclosure Statement and Background check form are signed.

Drag and drop files here or

Authorization

I authorize Orcas Power and Light Cooperative to solicit information regarding my character, general reputation, previous employment and similar background information, to verify all information provided in my application, and to contact all references given on my application. I hereby waive any privilege I may have regarding this information and release all persons connected with any such request from all claims, liabilities and damages arising out of the furnishing of such information. I agree that I have read, and will comply with, OPALCO Policy 23: Conflict of Interest I will disclose the following information or facts regarding any actual or potential income, employment,compensation, Conflicting Interest Transaction, Business Opportunity or pecuniary benefit, or otherinformation or fact that could impact my compliance with Policy 23. I certify that the facts and information in this application and in any attachments or supportingdocuments are true and complete to the best of my knowledge. I understand that any falsification,misrepresentation or omissions, as well as any misleading statements or omissions will because for denial of employment or immediate termination, regardless of when or how discovered. I certify that I am a member in good standing at OPALCO. I have read each of the above statements. I have also reviewed all of the information, the attachments and/or supporting documents I was provided in this application.

Yes

Send me a copy of my responses

Privacy Notice|Report Abuse