2019 Community Oregon Application

Thank you for your interest in Community Oregon. You will be notified shortly regarding the status of your application for the program.

* = required field

Self-nominations are accepted!

1. Applicant Contact Info

Home Address

If different than above.

Work Address

If different than above.

2. Applicant Personal/Demographic Information

Community Oregon seeks to include a broad range of Oregonians in this program in order to increase potential learning opportunities. While completion of the following section helps us ensure that we include participants from among the widest sample of Oregon residents as possible, you may skip a question if it causes you excessive discomfort. This information is for internal purposes only and will not be shared without permission. Thank you!

3. Applicant Biography

Please provide a biography of yourself.

(Be sure to save this text in another place on your computer before you submit this form, just in case something happens. We wouldn’t want you to lose your hard work!)(2-4 paragraphs)

Note: This information will be shared with other program participants and in press releases, as appropriate.

4. Applicant Statement of Interest

What most interests you about the program?

(Be sure to save this text in another place on your computer before you submit this form.)
(1-2 paragraphs)

Note: This information will be shared with other program participants and in press releases, as appropriate.

5. Applicant Photo

Please upload a photo of yourself. (Max file size: 4MB.)

6. Participation Agreement


Community Oregon is a program of Healthy Democracy designed as a response to the need to increase understanding and communication among diverse segments of Oregon’s electorate. Community Oregon will offer opportunities to create stronger relationships among the state’s citizenry in a way that will help build and sustain a healthier democracy in Oregon.


The program consists of:

  1. Community Oregon Camp – a three-day retreat taking place from Noon on April 25 through Noon on April 28, 2019 at Lake Creek Lodge in Camp Sherman, Oregon.
  2. Community Oregon Exchange – an opportunity for immersion in a community significantly different than yours. One urban to rural, and one rural to urban community visit will take place between 4-12 weeks following the Community Oregon Camp retreat. The venue and format of the exchange phase of the program will be determined primarily by Community Oregon program participants themselves with assistance from Healthy Democracy staff as needed. Logistics will be supported by Healthy Democracy staff as needed.
  3. Community Oregon Expo – a one day exposition to take place in the Portland area in the fall of 2019 (date to be decided by participants) that will include all Community Oregon participants and a number of special invitees. The purpose will be to showcase what you’ve learned and invite support for any collaborative projects that Community Oregon participants wish to develop or support as a result of their experience with the program.

Community Oregon participants will be reimbursed for all travel to the Community Oregon Camp, the Community Oregon Exchange, and the Community Oregon Expo . Expenses for accommodations for the Community Oregon Camp and the fall Expo (for those needing hotels) are also covered. Overnight accommodations for the Urban/Rural Exchanges will be comprised of host community homestays.


Community Oregon participants agree to commit to 100% attendance at all of the above program segments unless prevented from doing so by an emergency. This attendance policy is very important to the success of the program, so please give it careful consideration.


When engaged in partisan political activity, Community Oregon participants agree to avoid any reference to Healthy Democracy that could be construed as an endorsement by Healthy Democracy or the Community Oregon program.

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By typing your full name below, you acknowledge that you have read and understand these conditions of participation, and that you agree to abide by them if selected as part of the Community Oregon program.

Type first and last name.

Please click this Submit button only once. If you double-click the button, your application may not submit.

And be sure you’ve saved your Biography and Statement of Interest in another place on your computer. In the off-chance something goes haywire, we wouldn’t want you to lose your work!

Then, wait up to a minute for your photo to upload. You will see a confirmation message when we’ve successfully received your application.

If you have any trouble with this form, please email us at info@healthydemocracy.org.