Commission on - PDF document

1 Commission on Racial and Structural Equ
Commission on Racial and Structural Equity (RASE) Applicat ion for Commission Membership Thank you for applying to join Mayor Warren’s and County Executive Bello’s Commission on RASE. This is a joint, intergovernmental approach to eliminating inequities in Rochester and Monroe County. RASE has a specific charge to examine current, and recommend new, local laws and policies that will systematically dismantle structur al racism across our community. NOTE: Activities of the Commission on RASE may be subject to the Freedom of Information Law (FOIL) . By completing this application, you are agreeing to the availability of your name and likeness as governed by Open Meeting laws . This application can be completed online at https://www.rocrase.com/apply Name: ____________________________________________________________________________________________ Home Address: _____________ ______________________________________________________________________ __ Street Town Zip Code Preferred Phone #: _____________ _________ Email Address: ____________________________________________ ___ Employer, if applicable: ____________________ _____________________________________________________ ___ ___ In order to ensure there is a broad spectrum of diversity on this commission, we ask that you answer the following demographic information. While this information is not required, it will aid in the selection process. Age by Decade : 16 - 24, 25 - 34, 35 - 44, 45 - 54, Gender Identification: _______ ___________________________ (circle one) 55 - 64, 65 - 74, over 75 Years of Residency: __________ Education: _________________________________ Race/Ethnicity: ________________ In Monroe County ( I ndicate highest level of achievement) List other organizations/committees you are affiliated with ( faith , civic groups, fraternities/sororities, co mmunity group s, etc.) Name of Affiliation Position Length of time Ex. ABC Organization President

2 4 years
4 years Below are questions that will allow us to understand your desire to serve on the Commission on the RASE and identify your understanding of key focus issues. Please respond to the questions as honestly and open ly as possible . Please limit your responses to 200 words or less. 1. Tell us a little about yourself and why you are interested in serving on the Commission on RASE . ___________________________________________________________________________________________ ___________________________________________________________________________________________ __________________________________________________________________________ _________________ 2. What is your understanding of the connection between current laws/policies and racism? ___________________________________________________________________________________________ ___________________________________________________________________________________________ __________________________________________________________________________ _________________ 3. What role do you believe government can play in the elimination of racism ? ___________________________________________________________________________________________ ______________________________________________________________________ _____________________ ___________________________________________________________________________________________ 4. Give an example of a law y ou believe contributes to structural racism ? ___________________________________________________________________________________________ ___________________________________________________________________________________________ __________________________________________________________________________ _________________ 5. Please share an example of a time in which you made a positive change in our community. ___________________________________________________________________________________________ __________________________________________________________ ________

3 _________________________ ______________
_________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Please include 5 signatures of communit y /affiliation members who support your representation on this commission. NOTE: Family members are not eligible. References may be contacted. Name (Please Print) Email Address Phone Number Applications are due by 5pm Friday , July 10 , 2020 . Please email completed applications to : RacialEquityCommission@cityofrochester.gov Subject : Commission on RASE - OR - mail to: Commission on Race and Structural Equity Office of the Chief of Staff, Room 207A 30 Church St. Rochester, NY, 14614 I, _____________________________________ , attest that all information contained on this form is true, and I agree to abide by the expectations as set out below :  serve for a 6 - mon th period,  acknowledge and adhere to the charge established for th is commission,  engage respectfully in meaningful and honest conversation about race and structural racism,  demonstrate a willingness to hear and accept differing perspectives,  attend regularly scheduled meetings,  participate in professional development activities for commission alignment,  understand the goal of this commission is to affect the broader community context, not just one entity ,  agree to a consensus building model for decis ion making Signature of applicant: ________________________________________________________________________ By signing this document, you agree to the terms of the Commission on RASE and all governing county and city policy. If you are not selected for the commission , there may be other ways to engage in the activities sponsored by the commission. If you would like to be considered for other opportunit ies , please respond “ Yes ” here: ______________