LAAC Language Accessibility Advisory Committee Application The Placer County Language Accessibility Advisory Committee (LAAC) will meet on a regular basis to discuss methods of improving voting accessibility and participation for targeted language groups. Policy recommendations formulated at meetings will be reviewed by election officials and may be considered for adoption. All members are asked to remain on the committee for at least one (1) year from the date of the first meeting. _________________________________________________________________________ First Name (required) Middle Name Last Name (required) Residential Address (required) City (required) Zip (required) Mailing Address (if different from residence) City Zip Birth Date (required) E-mail (required) Cell Phone # (required) Home/Other # Do you speak and understand one or more languages other than English? YesNo If Yes, Specify: TagalogSpanishKoreanPunjabi If other language not listed, specify below: Are you a registered Placer County voter? YesNo Have you served on a LAAC before? YesNo If Yes, where: Are you a Placer County employee? YesNo If Yes, which department: Are you currently or intend to be a candidate for office, or a current officeholder? YesNo Are you willing to attend quarterly meetings in-person and/or virtually? YesNo Do you have experience working on accessibility issues pertaining to targeted language groups? YesNo If Yes, please describe your relevant experience in the space below. Do you have experience participating in an election or outreach in engaging community members? YesNo If Yes, please describe your relevant experience in the space below. By submitting this application, I am affirming that I am formally applying for membership with the Language Accessibility Advisory Committee for Placer County, and that I commit myself to being a member of the committee for at least one (1) year from the date of the first meeting I attend. CONTACT US For all questions and inquiries regarding the Language Accessibility Advisory Committee, please contact us. We’d love to hear from you! Phone: 530-886-5650 (toll-free in CA 1-800-824-8683) Email: [email protected] Δ