GRAND JURY APPLICATION FORM 2000

The California Penal Code (Section 893) sets forth the qualifications of Grand Jurors. The following eight questions are included to determine that you meet the Penal Code requirements.
Are You:	Yes	NO	Are You:	Yes	NO
1. A United States citizen?			5. Currently serving as a trial juror?
2. Eighteen years of age or older?			6. Within one year of having been discharged as a grand juror?
3. A resident of the County and State for one year?			7. Convicted of malfeasance in office or any felony?
4. English speaking?			8. Serving as an elected public official or an elected member of a public agency board?
PLEASE COMPLETE:
u How many miles (round trip) is it from your residence to the Eric Rood Center?_______ miles u Are you now, or have you ever been, involved in litigation against Nevada County, its special districts or any local public agency? Yes No u Do you have any typing and/or computer or word processing skills? Yes No u Number of years in the community._________ years u Age Range: 18-25___ 26-34___ 35-44___ 45-54___ 55-64___ 65-74___ 75 and over___ u Gender Male Female u Race or Ethnicity [may select more than one]: a. White ___ b. Asian___ c. Black or African American___ d. Hispanic or Latino___ e. Native Hawaiian or other Pacific Islander___ f. American Indian or Alaskan Native___ g. Other race or ethnicity [please state]___ h. Decline to Answer___ u Years, if any, served on a regular Grand Jury___ u Occupation ________________________________________________ .
PLEASE EXPLAIN
1. Your experience within community organizations, public agencies and the length and nature of your job experience (s):___________________________________________________________________________________________
2. Past trial or Grand Jury experience:_________________________________________________________________ ______________________________________________________________________________________________
3. Any research experience, or investigative skills you have:_______________________________________________ ______________________________________________________________________________________________
4. Describe any problems you might have investigating any local county or city governmental department, private or non-profit agencies, and how you would deal with them:__________________________________ ______________________________________________________________________________________________
5. What do you think are some of the major problems facing city and county government?________________________ ______________________________________________________________________________________________
6. How many hours a month would you have available for participating on the Grand Jury?________________________ ______________________________________________________________________________________________
7. Describe personal goals you would like to accomplish or complete within the coming year July 1 – June 30? ______________________________________________________________________________________________
8. Describe any physical or sensory impairments (hearing, vision, etc.) you have:________________________________________________________________________________________ ______________________________________________________________________________________________
9. Please describe some of the qualities you have that have helped you contribute to community organizations and/or to your effectiveness in other work (past and present):______________________________________________________________________________________ ______________________________________________________________________________________________

Date: ____________________________________

Signed:______________________________________________________________