City of Thornton, City Clerk, Boards and Commissions
Election Commission Application

Election Commission

The Election Commission makes ward reapportionment recommendations, assists with activities on election day and establishes City election precincts, along with other duties that may be set by City Council.

Commission Membership

Membership consists of four or more citizens, with the City Clerk as Chair of the Commission. During their term of office, members cannot be candidates for elective City office. Meetings will be held during the ward reapportionment process and as needed.

Home Address (include City, State ZIP+4)

Please read the following, then type your name and date in the signature block below, and submit electronically, using the “Submit Application” button in order to complete the board application.

  • I certify that the facts and statements contained in this board application are true and correct. I further understand that false statements shall be sufficient cause for rejection of this application or for grounds to apply the penalty provisions of the Code of Ethics.
  • I further certify that I have not been convicted of a felony under the laws of the State of Colorado or in another jurisdiction.
  • I understand that falsification, omission or misrepresentation will result in a rejection of this application. Any falsification, omission or misrepresentation is evidence of perjury in the second degree.
  • I authorize the City of Thornton to conduct a criminal background investigation, with the understanding that any felony convictions found will become a matter of public record. I further understand and acknowledge my rights under federal privacy laws, including the Privacy Act of 1974, with respect to access and disclosure of information and hereby waive such rights with the understanding that any and all information furnished will be used only in connection with contracting procedures.
Your typed name here constitutes your signature.
Authorization for Background Investigation/Release of Information

I have completed and submitted an application/resume seeking employment with the City of Thornton ("City"). I hereby authorize the City to conduct an investigation into my background, and this authorization covers any time period prior to any offer of employment by the City and following such an offer. I understand this investigation may solicit information as it relates to a position from and include contact with the character references listed on my application, current and/or former employers, motor vehicle records, scholastic institutions, police agencies, financial institutions, health care providers, credit bureaus or credit reporting agencies, neighbors, friends, relatives, and/or other persons who may have information concerning my personal and/or professional life.

I hereby authorize any representative of the City and its agency (Consumer Reporting Agency) bearing this form to obtain any information from any of the aforementioned persons or organizations pertaining to my employment records and I hereby direct any such persons or organizations to release such information on request of the bearer. I hereby authorize a review and full disclosure of ail records, or any part thereof, concerning myself by and to said representative of the City whether said records are of a public, private or confidential nature. The intent of this authorization is to provide full and free access to the background and history of my personal life for the specific purpose of pursuing employment at the City of Thornton, which may provide pertinent data for the City to consider in determining my suitability for employment.

I consent to the release of any and all public, private and/or confidential information that any of the aforementioned persons or organizations may have concerning my work record, background and reputation, military service records, educational records, criminal history record, including any information contained in investigatory files, efficiency ratings, complaints or grievances filed by or against me, attendance records, polygraph examinations, and any internal affairs investigations and discipline, including any files which are deemed to be confidential and/or sealed as long as it is legally permissible to use against my qualification. I hereby consent to release of these records regardless of any agreement I have made with any person or organizations named herein.

I hereby knowingly release and agree to indemnify and hold harmless all persons and organizations referred to herein, and all others as the custodian of such records, including such organizations' officers, employees or related personnel, from any and all liability, including any liability or damages arising pursuant to state or federal laws, or damage of whatever kind including expenses and attorney fees, which may at any time result to me, my heirs, family, or associates from furnishing information in compliance or attempted compliance with this authorization for background investigation/release of information form. I further understand and acknowledge my rights under federal privacy laws, including the Privacy Act of 1974, with respect to access and disclosure of information and hereby waive such rights with the understanding that any and all information furnished will be used only in connection with employment procedures.

For and in consideration of the City's acceptance and processing of my application for employment, I agree to hold the City, its public officials, officers, agents (CRA), employees, and assigns harmless from and intentionally waive any and all claims and/or liability I might have against the City arising from the City's requests for information concerning my employment application or from its receipt of such information and dissemination of the information to the authorized and appropriate individuals employed by the City. Furthermore, I release and agree to hold harmless and indemnify the City against any claims that third parties should make against the City based on the City's request for information on my background or its receipt of such information from other persons or organizations of any kind.

A photocopy or facsimile ("FAX") copy of this release form will be valid as an original thereof, even though the said photocopy of FAX copy does not contain an original writing of my signature.

If I accept employment with the City, this form is valid for the period of my employment with the City and the consumer reports may be updated periodically at the discretion of the City.

Legal Name
Present Address
List any alias(es) or other names you have used in the past. This includes maiden name.

If under 18 years of age, parental consent is necessary

We (I) hereby grant consent to the City of Thornton to conduct background investigation on the above named individual as a part of the job application process and thereafter as warranted based on City Of Thornton policy in the event the above named individual is employed by the City.

Fair Credit Reporting Act Disclosure and Authorization

Disclosure

As an applicant for employment or a current employee of the City of Thornton, you are a consumer with rights under the Fair Credit Reporting Act. When any of the following circumstances exist, the City of Thornton may choose to obtain and use information contained in either a consumer report or an investigative consumer report from a consumer reporting agency about you when: (1) considering your application for employment, (2) making a decision whether to offer you employment, (3) deciding whether to continue your employment (if you are hired), or (4) making other employment-related decisions directly affecting you.

For explanation purposes, a “consumer reporting agency” is a person or business which, for monetary fees, dues, or on a cooperative nonprofit basis, regularly assembles or evaluates consumer credit information or other information on consumers for the purpose of furnishing consumer reports to others, such as the City of Thornton.

A “consumer report” means any written, oral or other communication of any information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which is used or expected to be used or collected in whole or in part for the purpose of serving as a factor in establishing your eligibility for employment purposes.

An “investigative consumer report” means a consumer report or portion thereof in which information on your character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with your neighbors, friends, associates or others with whom you are acquainted or who may have knowledge concerning any such items of information.

In the event an investigative consumer report is prepared, you may request, additional disclosures regarding the nature and scope of the investigation requested as well as a written summary of your rights under the Fair Credit Reporting Act.

Authorization

By signing below, I, , hereby voluntarily authorize the City of Thornton to obtain either a consumer report or an investigative consumer report about me from a consumer reporting agency and to consider this information when making decisions regarding my employment at the City of Thornton.

I understand that I have rights under the Fair Credit Reporting Act, including the rights discussed above. In accordance with the Fair Credit Reporting Act, if my employment is denied, based on information contained in a consumer report or investigative consumer report from a consumer reporting agency, the City of Thornton will so advise me and will supply the name and address of the consumer reporting agency making the report.

If I am employed by the City of Thornton this authorization shall remain in effect as long as I am an employee.

I acknowledge that I have received and read this Fair Credit Reporting Act Disclosure and Written Authorization form.

Your typed name here constitutes your signature.

If under 18 years of age, parental consent is necessary

We (I) hereby grant consent to the City of Thornton to conduct a consumer report or an investigative consumer report on the above named individual as a part of the job application process and thereafter as warranted based on City of Thornton policy in the event the above named individual is employed by the City.

Learn more about the Fair Credit Reporting Act at consumerfinance.gov/learnmore.