July 13, 2017

Dear Applicant:

King County is seeking county residents to serve on the King County Agriculture Commission. The 15-member board recommends agriculture-related policies and programs to the King County Executive and Council. Those interested should:

•	Have an interest in regional policies to preserve and enhance agricultural land; 
•	Have a strong knowledge of agriculture production, marketing, or financing in the region and county;
•	Support and promote a viable agricultural community; 
•	Have an interest in educating the public about the benefits of local agricultural products. 

Commission members serve as volunteers. Appointees cannot be staff or board members of any agency with whom the King County Agriculture Program contracts for services. Prospective candidates should be able to devote approximately eight hours per month to Commission activities. Applicants must be able to prepare for and attend ten meetings per year, which are held on the second Thursdays of January through May, July and September through December.  The meetings are usually held in Snoqualmie from 4:00 p.m. to 7:00 p.m., but are occasionally held in other agricultural areas of the county. There are approximately two to six commission committee meetings annually, depending on need, and members are encouraged to serve on one, or more, committees. 

The County is seeking diversity in age and ethnicity, geographic area and agricultural sector. A Commission member serves a 3-year term, renewable once.

To apply, complete and return the attached application form.  An interview with some current commissioners and staff may be requested prior to submission of a list of candidates to the Executive for consideration The Executive will select a slate of potential new Commission members and submit the list to the King County Council for confirmation.

For additional information about the King County King County Agriculture Commission, please see our web site at http://www.kingcounty.gov/environment/waterandland/agriculture/commission.aspx or contact Patrice Barrentine at (206) 477-1556, or by e-mail at Patrice.barrentine@kingcounty.gov.

King County Agriculture Commission
Application for Appointment

Please note that applicants must meet all of the following requirements:

►	Applicants must live in King County.
►	Applicants must not be a staff or board member of any agency that contracts with the King County Agriculture Program.
►	Applicants must be able to devote a minimum of 5 hours a month to Commission activities.
►	Applicants must be able to attend 9 meetings of the full Commission, which are held on the second Thursdays of January through June and September through December. The Commission meets from 4:00 p.m. to 7:00 p.m. The meetings are usually held in Issaquah from 4:00 p.m. to 7:00 p.m., but may be held in other agricultural areas of the county on occasion.
►	Applicants should be able to serve in a sub-committee. Committee meeting days and times vary.  There are approximately 2 – 6 meetings annually, depending on need. 

Farmers and others who have a strong knowledge of agriculture, food marketing or related financing are encouraged to apply.

Applicants who are recommended for appointment to the Commission will be required to complete a financial disclosure form. For additional information about the King County Agricultural Commission, please see our web site at http://www.kingcounty.gov/environment/waterandland/agriculture/commission.aspx or contact Patrice Barrentine at (206) 477-1556, or by e-mail at Patrice.barrentine@kingcounty.gov.

	  King County Boards & Commissions

Thank you for your interest in serving on a King County board or commission.  This application form is a “fill-able” form that includes some drop down menus.  To answer a question with a drop down menu, click inside the box and a down-facing arrow () will appear to the right of the box.  Click on the arrow and the drop down menu will appear.  Then scroll down until you find an answer for that question.  Please return your completed form to the person and address on the last page of this form.

Individuals interested in serving on a King County board or commission will be required to complete a King County Ethics Program Financial Disclosure Form within two weeks of being nominated to serve on a King County board or commission.  Individuals appointed to serve on a board or commission that is overseen by an agency independent of King County government are exempt from the financial disclosure filing requirement. 

Application Form
(A résumé may be submitted in lieu of submitting a completed application form)

Board/Commission for which you are applying:  
Agriculture Commission	

If you are not appointed to the board listed above, are you interested in serving on a different King County board or commission?  If so, which one(s)?
Please list boards of interest.	

Name – Please Print:
Enter First Name	Enter Middle Initial.	Enter Last Name.	
First	Middle Initial	Last	

Preferred Phone Contact Number:		Preferred Phone Type (Home, work or cell):
Enter preferred contact number.		Select phone type.	

Personal Email Address:
Enter personal email address.

Preferred Mailing Address:
Enter street address.	
Enter City	WA	Enter zip	
City	State	Zip	

Physical Home Address (if different):
Enter physical home address (if different.	
Enter city.	WA	Enter zip.	
City	State	Zip	

Current Employer:
Enter job title	Enter date of employment.	
Job Title	Date of Employment
	
Enter company name.	
Company Name	
Enter company’s street address.	
Street Address	
Enter city.	WA	Enter city.	
City	State	Zip	

King County Council District:	Choose one.	

Education (High School, College/University:
Enter school name.	Enter year graduated or degree.	
Enter school name	Enter year graduated or degree.	
Enter school name	Enter year graduated or degree.	

Computer Program & Skill Level:
All King County board and commission members are issued King County email accounts upon appointment for conducting board business only.  In addition, meeting materials are only transmitted to board members via the board member’s assigned King County email account (If a board member does not own a computer we will make every effort to determine the best method for transmitting board material to them). In an effort to know which computer programs you are most familiar with, below are the computer programs used most frequently by King County staff. Using the drop down menus next to each computer program listed below please click on the choice that best describes your skill level with each program.  (This information is for staff use only and is not a factor in the appointment process.)

Program:	Skill Level:
MS Outlook (Email):	Choose one.
MS Word:	Choose one
Excel:	Choose one
PowerPoint:	Choose one
Adobe (PDF’s, Adobe Reader, etc.):	Choose one

Professional licenses held (If applicable to specific board/commission):
Enter professional licenses held.	

Memberships on any city and/or county boards, commissions or committees and dates of terms:
Enter Membership Info.	

How did you learn of this opportunity?
Explain.	

Please explain why you feel you are the most qualified candidate for this appointment:
Explain	
What interests you about serving on the King County Agriculture Commission?	

Please indicate which of the following categories best describes you: (check all that apply)

 Family / Friend Advocate
 Consumer (Personal experience in King County mental health services)
 Professional
 Interested Citizen

Date of Birth:___________________________________________________________________

PERSONAL INFORMATION (OPTIONAL):
The King County Council and the King County Executive are committed to inclusiveness and outreach to all King County residents to ensure that King County boards and commissions are reflective of the community we serve.  Providing information in the section below is voluntary but will assist in achieving this goal.
	
Race/Ethnicity:
Choose one.
Do you have a disability as defined by the Americans with Disabilities Act (ADA)?
Choose one.

Orientation:
Choose one.	Gender:
Choose one

Generation:
Choose one.	

I am available to accept an appointment to the King County Agriculture Commission for a term not to exceed three years.

			
Signature		Date

Please return completed form to (we accept scanned copies of the signed application):

	Patrice Barrentine
	201 S Jackson, Suite 600
	Seattle, WA  98104
	Direct Line:  206-477-1556
	
	Patrice.barrentine@kingcounty.gov

This material is available in alternate formats for persons with disabilities.
Please contact 206-263-9651, TTY Relay:  711, or 
E-mail Rick.Ybarra@kingcounty.gov 

King County Agriculture Commission
Application for Appointment – Supplemental Questions

Please respond to the following. 

1.	Section 2.40.030 of the King County Code specifies the interest categories that should be represented on the Commission. In the list below, check the box next the category (or categories) that you represent.

 Beginning Farmer/Rancher (0-5 years)

 Experienced Farmer/Rancher (6+ years)

 Farm Worker/Employee 

 Farm orFood Financial/Business Manager

 Restaurant

	 Grocery Store

 Farmers Market/CSA*/Farm Stand Management
*Community Supported Agriculture

 Food/Ag NGO

 Food Truck/Catering Food

 Food/Feed Processor
 Food/Beverage Producer

 Academic or agriculture associations

 Agriculture Real Estate
 Other. Please Explain: __________ _______________________________

2.	What crops/products are you working with? Please check all that apply.

 Dairy Fluid Milk

 Cheese

 Vegetables 

 Mushrooms 

 Tree Fruit/Berries 

 Eggs
 Honey
 Beef
 Pork
 Lamb
 Poultry
 Beverages
 Hay
 Forage
 Grains
 Cut flowers
 Nursery Products
 Christmas Trees
 Other. Please Explain: __________ _______________________________

3.	If a farmer/rancher, does your farm cover? Please check all that apply.

 0-5 acres
 6-20 acres
 21-40 acres
 41-100 acres
 101-500 acres
 501 acres or more

4.	List your affiliations with organizations that are pertinent to the Commission and are not already listed on the Boards and Commissions Application Form.

Additional Pertinent Organizational Affiliations	Served from - to	

		

5.	References: please supply the names and phone numbers of two references.

Name	Phone Number	

Thank you!