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2018 Board and Commission General Application <br />Page3of4 <br />Please note: <br />L <br />Cit �,t Louisville <br />c L1[1 :}.f?61• .INCE 1.876 <br />All Board and Commission members serve without compensation. <br />Anyone applying to a Board or Commission is subject to a background <br />check. <br />The City may reject an applicant for any lawful reason. An appointed Board <br />or Commission member may be removed during his/her term of office for <br />cause as defined in the City Charter and Resolution No. 16, Series 2009. <br />Reasons for rejection or removal from office include, without limitation, <br />where a background investigation reveals an arrest, conviction, or pending <br />charges for a criminal offense (excluding minor traffic violations). <br />All information on this application is public record and may be available for <br />public review. <br />I certify the information in this application is true and complete. I understand <br />false statements, misrepresentations or omissions of information in this application <br />may result in rejection of this application. The City is expressly authorized to <br />investigate all statements contained in this application and, in connection <br />therewith, to request a criminal history. I consent to the release of information <br />about my ability and fitness for volunteer assignment by employers, schools, <br />criminal justice agencies, and other individuals and organizations to <br />investigators, personnel staffing specialists, and other authorized employees of <br />the City of Louisville, and release all parties for all liability for any damage that <br />may result from furnishing such information. <br />In the event that I am selected to serve on a City of Louisville Board or <br />Commission, I agree to comply with all of its ordinances, rules, and regulations. I <br />fully understand and agree to provide my services to the City of Louisville as a <br />volunteer in a voluntary capacity and that I will receive no compensation or <br />benefits for services provided. <br />I understand that I am NOT insured by the City of Louisville Worker's <br />Compensation Insurance and NOT covered by any Accident Medical Insurance <br />Policy while I am a volunteer with the City of Louisville. I authorize that all <br />necessary first aid steps may be taken as prescribed by qualified personnel. <br />I grant full permission to use any photographs, videotapes, recordings or any <br />other record of my volunteer participation as a Board or Commission member. <br />The City will provide any applicant who is rejected as a result of a background <br />investigation information on how to obtain the report and contact information <br />for the reporting agency. Determinations to reject an applicant as a result of the <br />criminal background investigation report are final. <br />12 <br />