City of Chula Vista - Boards and Commissions Application Form

Boards, Commissions and Committees Application Form

APPLICATION
For Membership on City Boards, Commissions and Committees

Please indicate your areas of interest by checking the boxes below.

Board of Appeals & Advisors

Board of Library Trustees

Cultural Arts Commission

Housing Advisory Commission

Mobile home Rent Review Commission

Planning Commission

Resource Conservation Commission

Veterans Advisory Commission

Youth Action Council

If you checked more than one box, which would be your:

First choice?
Second choice?
Third choice?
Prefix	Mr. Mrs. Ms.
*First and Last Name
*Home Address
City
Zip
Residence Phone
Business Phone
*E-mail
*Are you registered to vote in Chula Vista?	Yes No
*Do you live within the City limits of Chula Vista?	Yes No	How Long?
Present employer
Position
*Are you currently serving on any board or commission for Chula Vista or any other governmental agency? Yes No
Which ones?
*Have you previously served on any board or commission for Chula Vista or any other governmental agency? Yes No
Which ones?
*Are you or have you been involved in any local, civic or community groups? Yes No
Which ones?
*What are your Principal areas of interest in our City government, and what experience or special knowledge can you bring to those areas?
*What would you hope to accomplish by your participation?
I am familiar with the responsibilities of the Boards, Commissions or Committees on which I wish to serve. By submitting this application, I hereby attest that the above information is accurate and true.