THE APPOINTMENT PROJECT (TAP)

The Women’s Leadership Initiative is a program of the Carl Albert Congressional Research and Studies Center at the University of Oklahoma. We are a nonpartisan, non-profit program working to address the underrepresentation of women in public service and elected office. TAP includes representatives from both gubernatorial campaigns and organizations. We will not endorse any applicants or potential appointees.

We are gathering information for the sole purpose of transmittal to the new Governor and her transition team. We will not disclose your information to any other group or individual without your express permission. If, however, we are required by law to disclose the information, we will make every reasonable effort to contact you before it is disclosed.

By submitting your information, you will be included in the materials we present to the Governor and her transition team. It may be necessary to submit additional material through the Governor’s office at a later date.

Please proof read your application carefully before submitting it. The Appointments Project, the Women’s Leadership Initiative, the Carl Albert Congressional Research and Studies Center, and the University of Oklahoma are not responsible for misstatements or factual errors on the part of the applicant.

The information contained in the form below is included on the application for appointment on the current Governor’s website. These are questions typically asked of applicants.

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Name:
Your Preferred Name:
Email Address:
Date of Birth:
Positions Sought:
Address:
City:
State:
Zip:
Phone (home):
Phone (cell):
Spouse's Full Name:
Professional title:
Business/Firm/Office:
Business address:
Business city:
Business state:
Business zip:
Business phone:
Business fax:
Business email:
Current employment (job description, employment date, supervisor):
Brief summary of job duties (limit 300 characters):
Previous employment or experience:
Professional References (name, title, contact phone number):
Military Serivce Record (awards, decorations, etc):
Please list any special interests or characteristics which might be important to serve on a Board or Commission:
Have you ever been elected or appointed to any public office, board or commission in the State of Oklahoma? Yes
No
If you selected Yes on the question above, please list with dates served:
State Senator:
State Representative:
Your Congressional District:
Registered voter: Yes
No
County you are currently registered to vote:
Please state your ethnicity (OPTIONAL):
Party Affiliation (OPTIONAL):
Gender: Male
Female
High School Attended (city, state):
College/Law School Attended (city, state):
Professional licenses & Certificates (include dates received):
Organizations and Memberships:
Are you currently or have you ever been a registered lobbyist:
List any family member who is currently an employee, appointee or elected official with the State of Oklahoma. List name, title, entity and location if applicable:
Please let us know why you would like to be considered for appointment. (limit to 300 characters):

While we are not requesting you to complete the questions in the section below, please be advised that the following questions are included on the current Governor’s application form and you may be asked to provide this information to the Governor’s office at a later date.

Do you have any financial or other interests that might present a conflict of interest, or the appearance of such a conflict, if you were to be appointed to the position for which you have applied?
If you selected Yes on the question above, please explain.

Is there anything in your background that might become an embarrassment to you if it were to become public?
If you selected Yes on the question above, please explain.

Have you ever been convicted of or found to have committed a crime or offense (do not include traffic offenses for which the fine was less than $200)?
If you selected Yes on the question above, please provide additional details (including date, court, crime and sentence) of: Each felony conviction; Each traffic violation resulting in a jail sentence (actual or suspended) or fine in excess of $200; Each misdemeanor resulting in a jail sentence (actual or suspended) or a fine in excess of $200.

Citations - Have you ever been cited for a breach of ethics for unprofessional conduct by, or been named in, a complaint to any court, administrative agency, professional association, disciplinary committee, or other professional group?
If you selected Yes on the question above, please provide details.

Tax Compliance - Are you currently in good standing with the Oklahoma Tax Commission and the IRS?
If you selected No on the question above, please explain.

Have you ever NOT been in compliance or in good standing with the Oklahoma Tax Commission or the IRS?
If you selected Yes on the question above, please explain.

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THE  UNIVERSITY  OF  OKLAHOMA  IS  AN  EQUAL  OPPORTUNITY  EMPLOYER.
© The Board of Regents of the University of Oklahoma.
1/2011