Facilities Advisory Committee Application

1.	Please select boxes for all that apply:
	Community Member  Subject Matter Expert  Employee Representative  K-12 Ed. Leadership  Liaison from another   D11 committee  Former Parent/Guardian  Current Parent/Guardian  Other   Other, please specify

2.	Name of school(s) your student(s) attended:

3.	Name:

4.	Address:

5.	City, State, Zip Code

6.	Phone Number:

7.	Cell Number:

8.	E-Mail Address:

9.	How long have you lived in Colorado Springs?

10.	In a short paragraph, please describe why you would like to participate on this committee? (Include personal background and why you believe you are a good fit for this committee.)

11.	Please list any previous experience working on committees that required a high level of facility advisory responsibility.

12.	Why do you think this committee is important to D11 and the Colorado Springs community as a whole?

13.	Which days of the week and times are you available for committee meetings?

14.	Are you able to agree to a multi-year commitment?
	Are you able to agree to a multi-year commitment? YesNo

15.	Do you have any restrictions or limitations for serving on this committee that we should be aware of?

16.	If not selected, I am willing to serve on an adhoc or subcommittee.
	If not selected, I am willing to serve on an adhoc or subcommittee. YesNo

17.	If not selected, I am willing to serve on another District 11 committee.
	If not selected, I am willing to serve on another District 11 committee. YesNo

	Please click this link for District 11 committee list: https://www.d11.org/cms/lib/CO02201641/Centricity/Domain/67/Committees.pdf

18.	If not selected at this time, I am willing to be contacted about serving if a vacancy occurs.
	If not selected at this time, I am willing to be contacted about serving if a vacancy occurs. YesNo