HomeMy WebLinkAbout2/7/2001 - STAFF REPORTS (26) SUBMIT APPLICATION DATE
BY 3/,3 I/O 1
CITY OF PALM SPRINGS
BOARD/COMMISSION APPLICATION FORM
Name of Board or Commission s ! 2m
on which you would like to serve: ro v� bra/ lrc•� h,'S vt ;
(ONE"MCAMNFERBO /COMMI&910N,lAfff C/F,
NAME
HOME ADDRESS dYv /_'. 131Z f.1torz e
TELEPHONE f REGISTERED VOTER
(Cr G�m Vmff)
110-2Go -395- 3a Iy I Office:3-'23 -1/sk/a YES I NO I
Length of Residence in Palm Springs:
Occupation&Employer:
.yGri,�f'Gives s �-P.o"yJ�Q 1� �i/vive,✓'
(or Former, if Retired) Z 2 3_ 11W3
Local Reference:
NAME TELEPHONE
Regarding the commission you are applying for, list dates of its most recent meetings you have
attended
The following information will be used by the City Council, and/or a subcommittee thereof, to select final applicants
to be interviewed by the City Council, in making recommendations to the Mayor for appointments.
FACTORS TO BE CONSIDERED:
Resident®istered voter in Palm Springs
Background, education, experience to demonstrate knowledge and sound judgment
Social, Ethnic and cultural diversity in commission membership
Attendance at commission meetings prior to interview
BIOGRAPHICAL SKETCH
(Do not attach additional materials)
EDUCATION `
��,�« . df'
BACKGROUND [WORK EXPERIENCE/CIVIC INVOLVEMENT:
d�e� r--5 '-7WP7i�'�
a
(Over)
PLEASE PRINT
(Continued)
Describe your knowledge of the functions, regulations and procedures of the commission which you
would like to serve.
2-y af,e 1o7
1o.aap
7411, ,, 6 )1
Uxns Ad GlP7�oY2�i'� e i J L� PP aSP3 ,z�2 / . SfiV f/0�--
What specific attitudes, skills and expertise do you think you have to enhance the work of the
commission?
h
What specific issues or problems face the board/commission? Do you have any suggestions to address
those issues or problems?
y N� 1'�14z�- -,z- 41,0
Additional qualifications for the Rent Control Commission are:
a)applicant may not be a landlord or tenant subject to the rent control ordinance;
b)must submit a verified statement as to present holdings and interests in real property in the City.
YES I am qualified, and my statement is attached (Form 7W Schedule A-2
` and/or 13)
SOCIAL SECURI NUMBER DRIVERS LICENCE
OPTIONAL
Revised: 10-21-98 C;���
11 P? n
SUBMIT APPLICATION Q �� TE
BY 3/3
CITY OF PALM SPRINGS c .
BOARD/COMMSSION APPLICATIO
Name of Board or Commission
on which you would like to serve: c)—t" eV T ��_ ow watt S ff
(ONEA UCADONPFRbOAm)/COM1A9SSION, 2)
NAME '(`r` I —
HOME ADDRESS SG q
ry TELEPHONE REGISTERED VOTER
(Cr CL'r MvemF)
Hare: Cd'}�- I omm: k" YES I v I NO
Length of Residence in Palm Springs:
Occupation&Employer:
�-1-���ta���r� Homes rn.�e Oe 4 <<c►4x�/'
(or Former, if Retired)
Local Reference: n
NAME* R<')(:C TELEPHONE
Regarding the commission you are applying or, list dates of its most recent meetings you have
attended �i Ci t-114, S C VOL -k c
k s
The following information will be used by the City Council, and/or a subcommittee thereof, to select final applicants
to be interviewed by the City Council, in making recommendations to the Mayor for appointments.
FACTORS TO BE CONSIDERED:
Resident®istered voter in Palm Springs
Background, education, experience to demonstrate knowledge and sound judgment
Social, Ethnic and cultural diversity in commission membership
Attendance at commission meetings prior to interview
BIOGRAPHICAL SKETCH
(Do Dot attach additio:,1 materials)
EDUCATION ` V� t CVMS 7P— CA)
BACKGROUND [WORK EXPERIENCE/CIVIC INVOLVEMENT:
Q t cQ t.d t`c t�*�^�Tlrptv� Ci.CP . �R "fb Qkc W �IW_ To.
8- ",A-�Ga(3 �s(3G corn/MU1tiry) srr10IMr
(Over) � ��
PLEASE PRINT
(Continued)
Describe your knowledge of the functions, regulations and procedures of the commission which you
would like to serve.
Ph&4b rCAR-10--V' cr,=`' C (>t-j 9- U IS
- 0.s n cc-Q. (a-
What specific attitudes, skills and expertise do you think you have to enhance the work of the
commission?
What specific issues or problems face the board/commission? Do you have any suggestions to address
those issues or problems?
Additional qualifications for the Rent Control Commission are:
a)applicant may not be a landlord or tenant subject to the rent control ordinance;
b)must submit a verified statement as to present holdings and interests in real property in the City.
YES I am qualified, and my statement is attached (Form 700 Schedule A-2
and/or B)
IISOCIAL SECURITY NUMBER DRIVERS LICENCE
OPTIONAL
Revised: 10-21-98 C