Application for membership on the Measure A Citizens' Oversight Committee

1

Prefix

Prefix

Mr.

Mrs.

Ms.

Mx.

Dr.

Other: If other, type text here.

N/A

2

Preferred Pronoun

Preferred Pronoun

He/Him/His

She/Her/Hers

They/Them/Theirs

Ze/Hir/Hirs

Ey/Em/Eirs

Other: If other, type text here.

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First and Last Name

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First and Last Name

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E-mail

 *

E-mail

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Home Address

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Home Address

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City

City

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ZIP code

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ZIP code

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Primary Phone

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Primary Phoneext.

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Secondary Phone

Secondary Phoneext.

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I certify that I am a resident of the City of Chula Vista and at least 18 years of age

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I certify that I am a resident of the City of Chula Vista and at least 18 years of age (Select an Answer) Yes No

11

How long have you been a resident of the City?   

How long have you been a resident of the City?

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Please click here to view the interactive map and verify your District of residency

I am a resident of the following City  Council district.

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Please click here to view the interactive map and verify your District of residency I am a resident of the following City Council district. (Select an Answer) 1 2 3 4

13

Present employer

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Present employer

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Occupation

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Occupation

15

Have you ever been employed by the City of Chula Vista?

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Have you ever been employed by the City of Chula Vista?

Yes

No

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If you have worked for the City of Chula Vista please provide the department and dates of employment. 

If you have worked for the City of Chula Vista please provide the department and dates of employment.

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Certain seats on the Citizens' Oversight Committee require nomination by specific Nominating Authorities. If you are applying for one of these seats, please select your Nominating Authority below; otherwise, select "none":

Certain seats on the Citizens' Oversight Committee require nomination by specific Nominating Authorities. If you are applying for one of these seats, please select your Nominating Authority below; otherwise, select "none":

None - I am a citizen applying for an at-large member seat

Chula Vista Chamber of Commerce

Chula Vista Police Officers Association (POA)

Chula Vista International Association of Fire Fighters (IAFF)

Association of Chula Vista Employees (ACE)

Chula Vista Fire Chief

Chula Vista Police Chief

Chula Vista Middle Management/Professional Employee Group

18

Are you currently serving on a Chula Vista Board/Commission?

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Are you currently serving on a Chula Vista Board/Commission?

Yes

No

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Which one(s)?

Which one(s)?

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Have you previously served on a Chula Vista Board/Commission?

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Have you previously served on a Chula Vista Board/Commission?

Yes

No

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Which ones?

Which ones?

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Are you or have you been involved in any local, civic or community groups?

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Are you or have you been involved in any local, civic or community groups?

Yes

No

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Which ones?

Which ones?

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What are your principal areas of interest in our City government, and what experience or special knowledge can you bring to those areas? (250 words or less)

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What are your principal areas of interest in our City government, and what experience or special knowledge can you bring to those areas? (250 words or less)

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What would you hope to accomplish in the role of a Member of the Citizens' Oversight Committee? (250 words or less)

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What would you hope to accomplish in the role of a Member of the Citizens' Oversight Committee? (250 words or less)

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I understand that to be considered, I must submit a resume along with this application.

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I understand that to be considered, I must submit a resume along with this application. Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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I am familiar with the responsibilities of the Citizens' Oversight Committee. I declare under penalty of perjury under the laws of the State of California that the information I have provided is accurate and true.

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I understand that this application and any documents submitted in connection with the application process are public records and may be publicly disclosed.

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Where did you hear about this vacancy?

Where did you hear about this vacancy?

City’s Social Media

Chula Vista Library

City’s Website

City Employee

City Board/Commission Member or Staff

Other (please enter text below) If other, type text here.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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