Application for membership on the Wildlife Advisory Group.

1

Prefix

Prefix

Mr.

Mrs.

Ms.

Dr.

2

First and Last Name

 *

First and Last Name

3

E-mail

 *

E-mail

4

Home Address

 *

Home Address

5

City

City

6

ZIP code

 *

ZIP code

7

Primary Phone

 *

Primary Phoneext.

8

Secondary Phone

Secondary Phoneext.

9

Are you registered to vote in Chula Vista?

 *

Are you registered to vote in Chula Vista?

Yes

No

10

Do you live within the City limits of Chula Vista?

 *

Do you live within the City limits of Chula Vista?

Yes

No

11

If yes, in which section of Chula Vista do you reside:

If yes, in which section of Chula Vista do you reside:

Northwest (North of L St/Telegraph Canyon Rd and west of Otay Lakes Rd)

East (All territory east of Otay Lakes Rd/La Media Rd)

Southwest (South of L St/Telegraph Canyon Rd and west of La Media Rd)

12

How long have you been a resident of the City?   

How long have you been a resident of the City?

13

Present employer

 *

Present employer

14

Occupation

 *

Occupation

15

Applicants are required to demonstrate involvement in one of the following areas. Please indicate which area(s) you have demonstrated involvement:

Applicants are required to demonstrate involvement in one of the following areas. Please indicate which area(s) you have demonstrated involvement:

Wildlife-related issues such as habitat restoration or wildlife management

Ecology, biology, chemistry, water quality or watershed protection

Ecosystem management and restoration

Nature-based or environmental education and similar fields

Wildlife rehabilitation and/or predator management

16

Please describe your involvement in the area(s) you selected above. (250 words or less)

 *

Please describe your involvement in the area(s) you selected above. (250 words or less)

17

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

 *

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

Yes

No

18

Which one(s)?

Which one(s)?

19

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

 *

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

Yes

No

20

Which ones?

Which ones?

21

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

 *

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

Yes

No

22

Which ones?

Which ones?

23

What would you hope to accomplish in the role of a Member of the Wildlife Advisory Group? (250 words or less)

 *

What would you hope to accomplish in the role of a Member of the Wildlife Advisory Group? (250 words or less)

24

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

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

25

 *

I am familiar with the responsibilities of the Wildlife Advisory Group. I attest that the information I have provided is accurate and true.

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

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