Form FR 1401 FR 1401 Application Form for Membership on the Community Advisor

Application Form
The Federal Reserve Board’s Community Advisory Council (CAC) is an advisory committee providing feedback and
advice to the Board on issues affecting consumers and communities. The CAC is composed of a diverse group of
experts and representatives of consumer and community development organizations and interests, including from
such fields as affordable housing, community and economic development, labor and workforce development,
financial technology, small business, and asset and wealth building. CAC members provide a range of perspectives
on the economic circumstances and financial services needs of consumers and communities, with a particular focus
on the concerns of low- and moderate-income consumers and communities.
If you are interested in being considered for appointment to the Community Advisory Council, please submit the
information indicated below. You may provide the application information through the online form below, by email to
[email protected] or by postal mail to the address listed below.

Application Information
Asterisks (*) indicate required fields.
Salutation

First Name *

Middle Initial

Last Name *

Suffix

E-mail Address *

Confirm E-mail Address *

Phone Number *

Organization *

Title *

Organization Type *

Primary Expertise *

Secondary Expertise

Address Line 1 *

Address Line 2

City *

State, Territory, or Federal District *

Zip Code *

Resume & Cover Letter
In addition to the information requested above, for consideration to serve on the CAC, you must provide a resume
and cover letter through the browse feature below, by email to [email protected], or by mail to the address below.
The resume should include information about past and present positions you have held, dates of service for each,
and a description of responsibilities. The cover letter should explain why you are interested in serving on the CAC as
well as what you believe are your primary qualifications. At your option, you may also provide additional information
about your qualifications.

File Upload

You may upload up to three files. Please ensure that no file is larger than three megabytes (3 MB). Only DOCX, RTF, and PDF files will
be accepted.

File 1
No file selected.
File 2
No file selected.
File 3
No file selected.
Mailing Address:
Federal Reserve Board of Governors
Attn: Community Advisory Council, Mail Stop I-305
20th St. and Constitution Ave. NW
Washington, DC 20551
The Board will use the information provided for the purpose of considering you for appointment to the Community
Advisory Council. The Board may contact you and may consider publicly available information in connection with
your candidacy. For further information, please see our Privacy Act Statement.
Check the box if you would like to receive a confirmation email.
Submit Application
Please direct questions to [email protected].

OMB Number 7100-0371
Approval expires May 31, 2019
Application is authorized pursuant to sections 2A and 10 of the Federal Reserve Act (12 U.S.C. §§ 225a and 244). The obligation to
respond is required to obtain the benefit of consideration for CAC membership. Information provided on the Application will be kept
confidential under exemption (b)(6) of the Freedom of Information Act to the extent that the disclosure of information “would constitute a
clearly unwarranted invasion of personal privacy” (5 USC § 552(b)(6)).
Public reporting burden for this collection of information is estimated to average 1 hour, including the time to gather and maintain data in
the required form, to review instructions, and to complete the information collection. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Secretary, Board of Governors of the
Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; and to the Office of Management and Budget, Paperwork
Reduction Project (7100-0121), Washington, DC 20503. The Federal Reserve may not conduct or sponsor, and an organization or a
person is not required to respond to a collection of information unless it displays a currently valid OMB control number.

Last Update: April 8, 2019