Historic Preservation & Cultural Resource Commission (Wait List)

2. Description:
   The Historic Preservation and Cultural Resource Commission will consist of five members whose responsibility is to advise the City Council, Planning Commission, and all City departments and staff on all matters relating to the identification, protection, retention, preservation, and registration of Cultural Resources in the City.

   The Historic Preservation and Cultural Resource Commission will consist of five members whose responsibility is to advise the City Council, Planning Commission, and all City departments and staff on all matters relating to the identification, protection, retention, preservation, and registration of Cultural Resources in the City.

4. Meetings
   Meetings occur on the second Monday of each month at 6:30 p.m. at the City Hall Council Chamber.

   Meetings occur on the second Monday of each month at 6:30 p.m. at the City Hall Council Chamber.

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

70. Address

71. City

72. State

73. Zip

75. 3. Name

76. Phone Number:

78. Address

79. City

80. State

81. Zip

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

85. 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.

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

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

    This field is not part of the form submission.

91. Submit Submit and Print

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