Section 1 of 1 in this document

Hudson River Rebuild by Design (HR-RBD) - Citizen Advisory Group (CAG) Application

Applications due by 5:00pm on 1/31/18

Contact Information

Ward # (see map: http://www.hobokennj.gov/docs/clerk/HobokenWardMap.pdf)

Phone Number

Demographic Information (Optional)

An important component of the RBD process and what will make the CAG a success is including a diverse range of individuals that reflect the community where the project is located. Please consider disclosing your date of birth, race/ethnicity, primary language spoken, and gender, all of which are optional.

Race/Ethnicity

Primary language spoken

Gender

Affiliations

Are you affiliated with any of the following types of organizations?

First Responder / Emergency Services

City Board or Commission

Business

Social or Environmental Community Based Organization

Design Professional

Environmental Justice Community

Please explain affiliations listed above, position and years served.

Please expand on your affiliations that will serve you best in your position with the CAG.

Interests

Why are you interested in joining the CAG, and how will the CAG benefit from your involvement?

Describe which component of the RBD project or process in which you are most interested:

Special Skills or Qualifications

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience

Summarize your previous volunteer experience.

Previous Work Experience

Summarize your previous work experience.

Please consider also attaching a copy of your resume. (optional, but strongly preferred)

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Commitment Guidelines

Please check off to accept each guideline (Required)

I understand that this is an advisory committee

I will attend at least one quarterly meeting (or as otherwise scheduled) during the term of the design contract for the HR-RBD project through the spring of 2019.

I will commit my time to this CAG as necessary (estimated 4-6 hours per month, slightly more for co-chairs)

I recognize that it will be a requirement to actively participate in outreach to bring awareness to public meetings

I recognize that there will be a procedure to remove members that have not complied with participatory requirements as well as a process to appoint new members from a waiting list.

I recognize that Citizen Advisory Group meetings will not be open to the general public.

Conflicts of Interest

We kindly ask that all applicants disclose all conflicts of interests that may give the appearance of impropriety, should you be chosen to sit on the RBD-HR CAG. (E.g. if you are a marine contractor that would stand to gain financially from sitting on this Group). Please note that you are not necessarily prohibited from sitting on the CAG if you have a conflict of interest. We will evaluate each application on a case-by-case basis to make a final determination. Should you be selected as a member of the CAG, we may request additional information regarding your conflicts.

Consideration for Co-Chair

The CAG will be led by at least two co-chairs. While co-chairs will be equal to all other members of the Group, it is expected that the co-chairs will lead CAG meetings, advise the City of Hoboken and NJDEP on agenda items, help schedule meetings, and serve as a primary point of contact for the CAG. Please note that the co-chair position will require a more substantial time commitment.

Please consider me for co-chair

Yes

Please provide a brief explanation as to why you would make an exceptional co-chair.

Agreement and Signature

First Name

Last Name

Choose how to sign

Draw Type

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal