Community Advisory Committee (CAC)Application

Community Advisory Committee (CAC)

Application

Please submit this application for yourself only. Note that certain information in the application is subject to disclosure under public records laws. Please e-mail Charlotte Sampson if you have questions about the CAC.

Name*

Telephone*

Phone

Home Address*

City (must be in Washington state)*

ZIP*

Email address

Occupation

If retired, please add "former" to the description.

Employer

Work Address

Work Telephone

Phone

School (if student)

Affiliations

Please list community groups you are affiliated with (volunteer, professional, etc.) and the amount of time you spend each month communicating with them or attending community meetings.

By checking this box, I declare my intention to commit up to four hours each month on committee activities, including in-person attendance at the monthly CAC meeting held typically on the last Thursday of the month at 6:30 pm at Kitsap Transit's administrative offices next to the Bremerton Transportation Center.

Yes*

Where did you learn that the CAC was accepting applications for new members?

Membership representation

In this section, please select the area, organization or Kitsap Transit service you wish to represent or advocate for. If you feel like you could represent both an area and a KT service, for example, you may select more than one. Please pick from at least one of the three dropdown lists below.

Geography

Select

Organization

Select

Kitsap Transit Service

Select

What public transportation issues are of concern and importance to you?

Select any of these Kitsap Transit services that you regularly use:*

Select

Why do you wish to be a member of the CAC?*

Demographic information (voluntary)

The CAC desires a broad representation of backgrounds and interests on the committee. The information you volunteer here will assist in this goal.

Race / Ethnicity

Select

Sex

Select

Age Group

Select

Disability

Select

Please describe the disability.

Send me a copy of my responses

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