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This application is for individuals interested in serving on the County of Los Angeles Governance Reform Task Force (GRTF).

Read for tips on applying.

You can complete the application online.

If you need to submit a hard copy application:

• Make sure you have all pages, including this page. Pages are numbered in the bottom right corners.
• Initial every page. If submitting a paper application, initial the top right corner of every page in the “Initial” box to make sure your application stays together.
• Print clearly and legibly or type your application. Doing so will speed up processing time. Unclear handwriting may cause delays.

Completely fill out the entire application. Incomplete applications may not meet the specified qualifications and could be eliminated.

Questions? Learn more at: MeasureG.lacounty.gov

Submit your application by the due date. This application must be received by Friday, March 7, 2025.

If you would like to submit your application online, click the “Next” button and follow the instructions. If you prefer to complete a paper copy, click the “Print” button below, fill out the form manually, and hand-deliver it to the designated location. If you need additional space to answer any questions, please attach extra documents to your paper application and specify the corresponding question number.

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Mandatory sections are indicated with a red asterisk.

1. Identification Information

2. Home Address

3. Mailing Address (If different from above)

4. Contact Information

5. Eligibility Information

To be considered eligible to serve on the GRTF, please confirm the following:

If needed, please visit the following website to identify which Supervisorial District you live or work in: Click here. If needed, please visit the following website to check whether you live or work in an unincorporated area of Los Angeles County: Click here.

Information about Form 700 can be found here.

6. Conflicts of Interest

Do any of the following circumstances currently apply to you or any of your immediate family members (spouse, child, in-law, parent, or sibling)? If you reply “Yes” to at least one of these circumstances, you are disqualified from participating on the GRTF.

If you currently hold any of the following roles, you are still eligible to apply for GRTF membership:

1. appointed staff not working directly for an elected official’s office,
2. a commissioner, or
3. an employee of an organization representing local cities.

These roles are exempt from the disqualifications listed above.

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Minimum requirements are qualifications that you must meet to be eligible to serve on the GRTF. Please provide detailed responses to the following questions.

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In this section, please highlight any additional skills and experiences you have that are desirable but not required for serving on the GRTF.

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The following questions are optional.

Please provide your demographics information to help support the final composition of the GRTF in reflecting the diversity of Los Angeles County.

17. Racial or Ethnic Background

18. Language Proficiency

19. Gender Identity and Sexual Orientation

20. Education Level

21. Income Level

22. Housing Status

23. Disability Status

24. Lived Experiences

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Purpose of Collection of Personal Information
This application seeks information from applicants that will be used to determine their qualifications for membership on the Governance Reform Task Force (GRTF) and for information-tracking purposes.

Consequence of Not Providing All Required Information
All individuals seeking membership on the GRTF must submit an application, including individuals selected by a Supervisor or nominated by labor organizations. Failure to provide all required information may result in disqualification and the removal of an applicant's name from the applicant pool.

Permission to Use and Release Information
In submitting this application, you are consenting to the County's use of the information you provide as necessary to select members of the GRTF and to comply with its legal duties. For these purposes, you acknowledge that your application materials may be provided to the Executive Office of the Board of Supervisors, Offices of each of the Supervisors, labor representatives from the Los Angeles County Federation of Labor, SEIU Local 721 and Coalition of County Unions, and County personnel involved with establishing and supporting the GRTF.

Additionally, please note that your application materials may be public records subject to the California Public Records Act (CPRA) and therefore subject to public disclosure unless an exemption under the CPRA applies.

Personal Information
At this stage, your application materials should not include your social security number or driver’s license number information. However, you may be required to provide such information later in the application process. You may also be required to provide proof of age and verification that you reside or work in Los Angeles County. If you are required to provide such information at a later date, the information will be kept confidential by the County to the extent permitted by law.

By affixing my signature below, I acknowledge that I have read and understand this Privacy Notification and Acknowledgement, and I declare under penalty of perjury under the laws of the State of California that the information provided in and submitted with this application are true and correct to the best of my knowledge.

You will receive a PDF copy of your application via email shortly after you submit.

If you do not receive a confirmation email within 24 hours, please contact us at support@measureg.lacounty.gov

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