HEAR Commission (Wait List)

2. Description:
   The purpose of the HEAR Commission is to advance and advocate for equity, access, diversity, social justice, safety, mutual appreciation, increased cultural competency, positive inter-group relations and respect for all members of the San Gabriel community.

   The purpose of the HEAR Commission is to advance and advocate for equity, access, diversity, social justice, safety, mutual appreciation, increased cultural competency, positive inter-group relations and respect for all members of the San Gabriel community.

4. The HEAR Commission serves as an advisory body to the City Council and reports directly to the City Council to assess and recommend policies, procedures and activities in the City government to advance the Commission’s purpose. The HEAR Commission is not an oversight board nor a body whose primary function is to receive or investigate individual incidents or complaints. The HEAR Commission may request and obtain information with respect to individual incidents or complaints, but only to the extent necessary to make policy, procedure or activity recommendations to the City Council.

   The HEAR Commission serves as an advisory body to the City Council and reports directly to the City Council to assess and recommend policies, procedures and activities in the City government to advance the Commission’s purpose. The HEAR Commission is not an oversight board nor a body whose primary function is to receive or investigate individual incidents or complaints. The HEAR Commission may request and obtain information with respect to individual incidents or complaints, but only to the extent necessary to make policy, procedure or activity recommendations to the City Council.

6. Meetings
   Meetings will occur monthly at a time and place to be determined by the City Council.

   Meetings will occur monthly at a time and place to be determined by the City Council.

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

   Please enter your personal data below.

10. First Name*

11. Last Name*

13. Phone Number*

14. Email: *

16. Home Address*

17. City*

18. State*

19. Zip*

21. Name of Employer

23. Work Address

24. City

25. State

26. Zip

28. 2. Work Experience

31. Describe your duties:

33. 3. Education and Training

35. Please comment on your education and training as it may relate to your application:

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

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

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

43. 7. Please share any personal experience, education or activities that demonstrate your interest in advancing the Purpose of the HEAR Commission.

45. 8. Do you have any restrictions pertaining to meeting attendance?

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

49. 9. 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

51. If yes, please explain:

53. 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.

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

    1. Yes
    2. No

57. References - Please provide three personal/professional references

59. 1. Name

60. Phone number:

62. Address

63. City

64. State

65. Zip

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

69. 2. Name

70. Phone number:

72. Address

73. City

74. State

75. Zip

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

79. 3. Name

80. Phone Number:

82. Address

83. City

84. State

85. Zip

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

89. 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.

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

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93. 1. Receive an email copy of this form.
94. Email address

    This field is not part of the form submission.

95. Submit Submit and Print

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