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  Office of the City Clerk

Historic Preservation Commission Application Form

For Membership on
Historic Preservation Commission


*First and Last Name
*Residence Address
*ZIP Code
*Primary Phone
Secondary Phone
*Are you registered to vote in Chula Vista? Yes No
*Do you live within the City limits of Chula Vista? Yes No *How Long?

*Please check the field(s) in which you qualify and/or have professional preparation or expertise:

A) Secretary of the Interior Qualification Standards (Certified local government requirements)

Cultural Anthropology
Landscape Architecture
Architectural History
Planning/Environmental Planning
Other - Please describe

B) California Realtor


License # (Proof may be requested)

C) Member with an interest, competence or knowledge in historic preservation

Please list your experience and/or education that demonstrates your knowledge of Historic Preservation.

*Have you previously served, or do you currently serve, on a Chula Vista Board, Committee or Commission
Yes No
*If yes, which one(s) and for what period of time?
*Are you, or have you been, involved in any local, civic, service or community groups?
Yes No
*If yes, please list them

*Please describe your interest, experience or specia l knowledge that you bring to this position. (250 words or less )

*What do you hope to accomplish in the role of a Historic Preservation Commissioner? (250 words or less )

*I understand that to be considered, I must submit a resume along with this application.
Yes No

Please email your resume to
I am familiar with the responsibilities of the Historic Preservation Commission. By submitting this application, I hereby attest that the above information is accurate.


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