HomeMy WebLinkAboutBrewer Applicationttltr
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CLALLAM COUNTY
BOARD & COMMITTEE APPLICATION
Retu¡nn Conopleted App[icatlon to:
Clallam County Human Resources Department
223F'4th St., Suite 16
Port Angeles, WA 98362-3015
Clallarn County ís an Eqwdf @ppartølnity Employer
& Ðrwg FreeWarkpface
FOR OFFICE USE ONLY
I NSTRI.'CTIOù¡S FOR COnÂp [-ETû ${G T[.{!S AppLrCATlOr{o Cømp,[ete tke aplplícation t:haraaqhfv" Applications that are incornplete will not be accepted. We will not accept "See ResLJme."
Resumes may be used to supplement an application, but may not be used in lieu of cornpleting the application form. Applications
that are incomplete (including "see resume", or do not list references) will not be accepted.o Be sure to sign your name and enter the date you signed it where lhe application asks. Original signature is required.o DO NOT double side the application - double sided applications will not be accepted.
GENERAL INIFORMATIOIII :
Name (Frsf, Middle lnitial, Last):
John C. Brewer
hlame of Committee:
Category fif applicable):
Clallarn County Opportunity Fund
Advisory Board (as City of PortAngeles
representat¡ve.)
Mailing Address:
510 S. Liberty St.
City, State, Zip:FortAngeles, WA,
98362
Resídence Address (if different frcm above):City, State, Zip
Day Phone:
Evening Phone:
360-452-4639
(MOBILE - 360-477-01 80)
Email:
jcbrewerS@gmail.com
Will you need access to a County computer: tr Yes El No Do you intend to drive on behalf of the County: tr Yes M No
(lf you said yes to the above guestion, a Drivins Abstract will be required.)
REFERE
WFiO CAN
VOU. NAñIIE, AÐDRESS Ah¡Ð PI.{Oû¡E ,S REQT.OIREÐ.
1. NAMEOFREFERENCE FNanclv.lohnson RELATToNSHTP Friend
ADDRESS Clallam Counfu Couthor¡se
(as a rnemben of the
Board of Commissioners)
CURRENT PHONE 360-417-2237
2. [{AME QF REFERENCE Leah Leach RELATIONST-ilP Former co-worker
ADDRESS Peninsula F)ailv News lwhere she is executive editorì
CURRENT PHONE 360-417-3530
3. NAMEOFREFERENCE Cherie Kidd RELATIONSHIP Friend
ADDRESS PortAnoeles Citv Hall lwhere she is a rnember of the Citu
CURRENT PHONE 360-477-1825
ncil)
R.evised 08/2016
Page 1 of3
EXPERIEI{GE
ADÞ[TlONAl- [NrFORhfr All'[@lN :
& LflcENSES
Summarize your experience, special skills and qualifications, includlng hobbies:
lwould to the board broad earned as a localjournalist,and editor and
businessman, 1998-20X5. Eefore retirinE in October 201 was all operations of the Feninsula Daily News
two week Gazette and Forks and the l-'lomes-Land real estate
magazine and those publications'news and advertisinE websites. I also have served on several boards and been president of
several orqanizations. I undergtand the board process and how to deal with differences of opinion. I can be supnortive or
disagree with positions and can respect the decisions of the board even if they differ from my own opinion
l''lobbies: Fly-fishing
Flaee of employment, if employed
Volunteer e;<perienee:Fresident, Fort Angeles Business Association, 2016, and FABA board member, 2016, 2017
Fort nal Fort
Association, 2005; President, Fort Angeles Multi-Gultural Alfiance (20A7,2008). President, Allied
Dailv Newspapers of Washinqton. a statewide press association. 2004.
Special training/eourses (inelude eomputer training):
Are you fluent in any languages other than English? El No E Yes. lf yes, please tist:
Explain why you wish to serue on this board/committee:
rowth, diversity and qualíty business a positive local to attract
am
th
to nE
I also believe in
eco
responsibility to preserve ourta
commu values and sensibilities.
arts, services, people and
Flease describe your education/career background University, Fon'¡ona,
(1 970)
Olympic llomes-t-and real estateanduim Gazette and Forks
Eroup
and those
newspapers
news and
newspaper,
of The New York Times NewsSalesln1 9BB-1 997 President/G EOIEd ito pi n-Ch ief New York'fimes
ng
Service, New York Tmes feature syndicate and New York ïmes Licensing and Permissions which handled trademark and
for The
1969-1987, The Associated Press. Reporter, editor, bureau chief {in charge of Seattle and Los AngelesAF bureaus) and New
R.evised 08/2016
Gou
Page 2 of3
Clallam County does not ace volunteers in positions of direct su pervision by a relative. Flease list any relatives (including
tvæt6Name of Relative:Department:
Name of Relative:Department:
EMERGENCY COFITAGTS:
Flease list two to in of
510 S. l-iberty St.
City:, State & Zip Code:
Phone: (l-{ome)
Name:Fiancee
Address:
1
Barbara Wise
WA 98362trort
City:, State & Zip Code:
Phone: (Home)
Name:
Address:
775-322-8554 775-848-0986
Douolas Brewer
us Drive
Reno.NV 89s09
2912
fr{otfiae üo Vo[u,¡mteers
Volunteers are not cons¡dered to be Clallam County employees for any p$rpose. lnjury compensation wlll be provided
as described ín the service agreement. The data furnished on this fors-n is furnished voluntarily and will only be used to
contact, interview and place volunteers in theír assignrnents. Volunteers are expected to track all hours served on the
time sheets provided. This is a requirement for volt¡nteering with Clallam Gounty and provides supplemental injury
eompensation, should that be necessary. Selection and disrnlssal as a volunteer is totally at the discretion of the
department head or elected official and may be witlr or without cause. No property rights are created by volunteering for
the County. INOTE: Based on quest¡ons answered in this document, additionaltraining rnay be required.
AGREEflIfr ENT dL CERTIFIGATION:
I HEREBY CERTIFY, UNDER THE PENALW OF PERJURY lN THE STATE OF WASI-¡II{GTOI{, Tl-t/AT THIS APPLICATIOIV CONTAINS l{O
WILLFUL MISREPRESENTATION AND TI-IAT THE INFORMATION GIVEI{ IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AT{D
BELIEF. IAM AWARE THAT SHOULD INVESTIGATIOI\ ATANY TIME ÞISCLOSE AISY SUCH MISREPRESEI{TATIOI\I OR FALSIFICATION, MY
APPLI ATIOI{ MAY BE REJECTED, Ai\D MY hIAME MAY BE REMOVED FROM CONSIDERATIOI{.
4,)W e May 17,2017
OF APPLICAI{T DATE
To A,pplv: The following five docurnents are included in the application packet and must be fully-completed
and subr¡ritted to Clallam Coun$ F{uman Resources in Fort,Angeles by the closing date
U a County Board & Cornmittee Application,
ú anotarized R.elease of Fersonal F{istory fonn,
E a Volunteer Disclosure
E a Volunteer Service,A.greement
il a Confidentiality,{greement
R.evised û8/2016
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