Grand Jury

General Information

First Name

Last Name

Middle Name

Maden Name

Residence Address

Address

City

State

Zip

Mailing Address (if different thatn above):

Address

City

State

Zip

Main Phone

Mobile Phone

DOB

SSN

County Supervisorial District

How did you hear about us?

If you were referred by a Grand Juror, Job Fair, Newspaper, Seminar/Presentation, and/or County Department, please provide more detailed information here.

Are you related to or closely associated with any elected official(s) or public employee(s) within San Bernardino County?

If yes, please give name and explain relationship:

Supplemental Questions

Why do you want to serve on the San Bernardino County Civil Grand Jury and what contributions would you have to make as a member? Please be specific and in-depth in your answer.(Attach additional sheets if necessary):

Please outline your knowledge and understanding of the role and function of the Civil Grand Jury and he role and function of County government. (Attach additional sheets if necessary):

If you think you may interested in being considered for the position of Foreperson of the Civil Grand Jury, please assist the Presiding Judge in the selection by summarizing your background, experience and why you believe you would be a good Foreperson. (Attach additional sheets if necessary):

If you are contemplating any absence in fiscal year 2017-2018 which might interfere with your your performance on the Civil Grand Jury, please indicate for what peried of time. Please specify effective date and return date below:

Return Date

If you are employed, does your employer understand the nature of the duties of a Grand Juror and will he/she release you to full-time Civil Grand Jury service for the entire period the Jury shall be in sessions? Attach release verification from your employer. (CAUTION: Employers are not required to pay wages to citizens volunteering for service on the Civil Grand Jury.)

Are you willing to take the following oath or affirmation?

GATHERING FACTS:

ANALYZING DATA:

REPORT WRITING:

COMMITTEE WORK (volunteer or paid):

Agree & Confirm

By selecting YES below, I acknowledge that I have read and agree to the disclosure terms and conditions regarding the Sheriff’s Department background check required for consideration of this application.

By selecting YES below, I acknowledge that I have read and agree to the disclosure terms and conditions regarding this application.

General Information

Residence Address

Mailing Address (if different thatn above):

Qualifications

Employment & Education

CLUBS/ORGANIZATIONS/COMMUNITY SERVICE: List any civic, professional, service or social organizations in which you have served as a member. Indicate if you have served as an officer.

Experience - Do you have experience with the following?

Writing Ability - Do you have experience with the following?

Communication Skills - Your degree of proficiency in English usage:

Computer Skills - Your degree of proficiency in computer usage:

To assist the Civil Grand Jury Selection Committee in its recommendation of the 30 names for the Civil Grand Jury Panel, it is requested that you summarize your backgroud and employment experience below. In addition to the following information, resumes will be accepted.

Supplemental Questions

Demographics

Agree & Confirm