City of Beaverton Form

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CMD Mediator Application

  1. If you don’t provide a correct email address, you will not receive a confirmation receipt of your application.

  2. When are you available? Check at least one option. Please indicate all available hours:*

    A regular schedule will be established upon selection.

  3. Some positions may require use of your own vehicle. Can you provide your own transportation?*

    A driving record check will be necessary if your position requires the use of a City vehicle.

  4. Please provide (2) personal references familiar with your skills, experience, or community activities whom we may contact:

  5. How did you learn of this volunteer opportunity?

  6. I hereby certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I agree and understand that any misstatements or material omissions on the application will result in my being eliminated from further consideration. I understand that, if accepted, any misrepresentation or material omission which becomes known to the City of Beaverton may result in my immediate dismissal.*

  7. Leave This Blank:

  8. This field is not part of the form submission.