Community Services Commission (Wait List)

2. Description:
   The Community Services Commission is the City Council advisory board on the subjects related to effectiveness of programs and policies as it relates to recreation and park programs in the City.

   The Community Services Commission is the City Council advisory board on the subjects related to effectiveness of programs and policies as it relates to recreation and park programs in the City.

4. Meetings
   Meetings occur on the first Monday of each month from October through June at 6:30 p.m. in the City Hall Council Chambers.

   Meetings occur on the first Monday of each month from October through June at 6:30 p.m. in the City Hall Council Chambers.

6. 1. Personal Data
   Please enter your personal data below.

   Please enter your personal data below.

8. First Name*

9. Last Name*

11. Phone Number*

12. Email: *

14. Home Address*

15. City*

16. State*

17. Zip*

19. Name of Employer

21. Work Address

22. City

23. State

24. Zip

26. 2. Work Experience

29. Describe your duties:

31. 3. Education and Training

33. Please comment on education and training as it may related to your application:

35. 4. Please enter your professional licenses, certifications or registrations:

37. 5. Please enter your personal and community affiliations:

39. 6. Briefly explain why you are interested in serving on this Commission:

41. 7. Do you have any restrictions pertaining to meeting attendance?

    1. Yes
    2. No
43. If yes, please explain:

45. 8. Do you or an immediate family member have any professional or financial relationship that may present a potential conflict of interest for this commission?

    1. Yes
    2. No

47. If yes, please explain:

49. Pursuant to the City's Conflict of Interest Code, members are required to file a Statement of Economic Interests (Form 700). Members are also required to complete AB1234 Ethics Training within one year of appointment and every two years thereafter.

    Pursuant to the City's Conflict of Interest Code, members are required to file a Statement of Economic Interests (Form 700). Members are also required to complete AB1234 Ethics Training within one year of appointment and every two years thereafter.

51. Are you willing to file a Statement of Economic Interests and complete AB1234 Ethics Training as required?*

    1. Yes
    2. No

53. References - Please provide three personal/professional references

55. 1. Name

56. Phone number:

58. Address

59. City

60. State

61. Zip

63. Reference Type*
    -- Select One --Professional ReferencePersonal Reference

65. 2. Name

66. Phone number:

68. Address

70. City

71. State

72. Zip

74. Reference Type*
    -- Select One --Professional ReferencePersonal Reference

76. 3. Name

77. Phone Number:

79. Address

80. City

81. State

82. Zip

84. Reference Type*
    -- Select One --Professional ReferencePersonal Reference

86. Disclosure
    Please note that this is a record that is subject to disclosure under the California Public Records Act.

    Please note that this is a record that is subject to disclosure under the California Public Records Act.

88. You may attach a resume and/or additional pertinent information.

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90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit Submit and Print

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