RFQ 2024-52 Resolution Services Application-fillable~1.pdf

Revised 9/2024 Page 11

Clackamas County Resolution Services

Conflict Resolution Specialist Application

Applications must include the following items:

● Completed Conflict Resolution Specialist Application Form

● Cover Letter addressing your specific interest in the listed service areas

● Professional Resume that includes 3 references with name, phone number, and email

● Completed Quote Certification Form

● (If applicable) Affirmation of Identity Form

● Any additional information that Clackamas County should take into consideration for the project or qualifications (not required)

I. Applicant information:

First Name: _______________________________________________________________

Last Name: _______________________________________________________________

Address: _________________________________________________________________

Phone: ___________________________________________________________________

Email: ___________________________________________________________________

Bilingual ☐ Yes ☐ No

If yes, list which language(s):

Hours of direct conflict resolution service:

☐Mediation:

☐Restorative Justice:

☐Training:

☐Lived Experience (30 hours is the maximum allowed in this field. Please complete the attached Affirmation of Identity):

Applicants must have a combined total of 100 hours in these areas to be considered.

The county may ask for additional documentation regarding hours listed.

I am applying for this pay rate:

☐Conflict Resolutions Specialist

☐Bilingual and/or Lived Experience Conflict Resolutions Specialist

☐Senior Conflict Resolutions Specialist

☐Senior Bilingual and/or Lived Experience Conflict Resolutions Specialist

Revised 9/2024 Page 12

II. Check the service areas for your requested interest below:

Applicants do not need to meet the program specific requirements at this stage to indicate interest.

☐ Skill Development/Training

● Parenting Education Class Instructor

● Basic Mediation Trainer

● Coach

● General Public Trainer

● General Mediation Trainer

☐ Mediation/Conflict Resolution

● Manufactured and Marina Resource Center Mediator (MMCRC)

● Landlord Tenant Mediator (LTM)

● Public, Organizational, and Workplace Mediator

● Intra-Family Mediator

● Adoption Mediator

● Civil Court Case Mediator

☐Facilitation

● Oregon Foreclosure Avoidance Facilitator

● Organizational and Workplace Facilitator

● Public Policy Facilitator

● Restorative Dialogue Facilitator

☐Outreach/Data Collection/Marketing/Advising

● General Projects

● Resolution Services Advisory Committee

☐Cultural Competency Support

● General Projects

● Translation/document translation review

☐Other

● Additional Service Areas and Scopes of Work created as needed

Revised 9/2024 Page 13

Affirmation of Identity Form (Optional)

Lived Experience pay rate will require the applicant to complete this Affirmation of Identity document and include it in their application packet.

Please note that if you are part of an Underserved Population, you are not required to complete the

Affirmation of Identity to apply. The request is for those asking for the 10% increase in base pay due to the additional skillset and knowledge they bring to their work.

Clackamas County supports and acknowledges the additional knowledge and expertise that comes with living an identity that is historically marginalized.

1. Mark any of the following Underserved Population(s) to which you belong:

A specific racial or ethnic community

Please specify:

Disabled person

U.S. military veteran

Immigrant and/or refugee

LGBTQIA+

Other

Please specify:

2. In what ways do you use your experience of being the ident(ies) above in your conflict resolution work?