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2014 Board and Commission Application <br /> City,r <br /> Page 3 of 4 Louisville <br /> SCHEDULING CONFLICTS: <br /> What times Monday through Thursday are you generally unavailable to attend meetings? <br /> (The meeting times of each board are available on the City's web site at <br /> www.LoulsvilleCO.gov.) <br /> C ��5 <br /> DISCLOSURES: <br /> Within the last ten years, have you ever been convicted of a crime or received a <br /> suspended sentence, deferred sentence or deferred prosecution, or forfeited bail, for <br /> any offense in criminal or military court, or do you have any crimjlial charges currently <br /> pending against you? Exclude minor traffic violations. ❑ YES I NO If yes, list for <br /> each case: <br /> (1) date of offense; (2) charge; (3)jurisdiction; (4) court name and (5) disposition: <br /> v been Within the last ten years, has your driver's license in any state ever be suspende or <br /> revoked, or have you ever been denied a driver's license in any state? ❑ YES 1, NO <br /> If Yes, please explain below: <br /> Have you ever been Involved in an incident involving child/elder abuse or child/elder <br /> neglect for which a report was filed yvith or issued by any law enforcement agency or <br /> social services agency? ❑ YES Ga'NO If Yes, please explain below: <br /> Do you or a/company you work for or own do business with the City of Louisville? <br /> ❑ YES MAO If Yes, please explain below: <br /> • All Board and Commission members serve without compensation. <br /> • Anyone applying to a Board or Commission Is subject to a background check. <br /> • The City may reject an applicant for any lawful reason.An appointed Board or <br /> Commission member may be removed during his/her term of office for cause <br /> as defined In the City Charter and Resolution No. 16, Series 2009. Reasons for <br /> rejection or removal from office Include,without limitation,where a background <br /> Investigation reveals an arrest, conviction, or pending charges for a criminal <br /> offense (excluding minor traffic violations). <br /> • All Information on this application is public record and may be released for <br /> public review. <br /> • Questions about a board/commission or the application process may be <br /> directed to Meredyth Muth at MeredythM @LoulsvilleCO.gov or 303.335.4536. <br /> 57 <br />