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~'I1c. OF SAN BERNARDI(::P - REQU~T FOR COUNCIL AC1:.I,ON
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From:
Mayor Evlyn Wilcox~~~ect:
Dept:
Mayor's Office
198UflR 22 AM 3; 22
Appointment - Samantha Ingham to the
Commission for the Disabled as
Requested by Mayor Wilcox
Date: April 20, 1988
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Synopsis of Previous Council action:
Recommended motion:
That the appointment of Samantha Ingham to the Commission for the
Disabled, as requested by Mayor Evlyn Wilcox, be approved.
-i~1l~
Signature .
Canteet ptrlOn:
Mayor Wilcox
Phone:
5051
Supportl", dltllttlched:
Yes
Wird:
FUNDINd "IOUIREMENTS:
Amount: N/A
Source: (ACCT, NO.)
(ACCT. DESCRIPTION)
Flnence:
Council Notelt
15-0262
Agenda Item No._ .
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cO OF SAN BERNAQNO
Application for Consideration for.Appointment
to Citizen C~ission or C~ittee
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Personal !)a~a
::'......., ~~~~F '-~ ~1Q.~~~6
Date of Birth: 'v~/13J IClQ~ Telephone: ~- fbT1 92<fID
Have redded in the city of San Bernardino since ~t.. "- <
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Marital status: <3:~-
L.1b~\"7
Comaunity Affiliations:
..~r;> ~ J<wNn
Educa~ion
-<:::"" . N ~"-O .\~~ G" I EC~
~ffi)
Past EmDlovment
("""}-i<<C-KL:> ~-k.\) ~\o~,-
CUrrent EmDlovment
Firm Name:~ ..<::JiLF - B1.~t1f)
Address: {r:s ~. ~ k ~ C. ~A...-I
Phone: &'t:--.. - ~Z:-?
~ C~ q~ilb >;02;
Please Indicate What committees
ation For: ""',...... Fo~
Have you ever bee~ convicted of a felony? Yes___ N~-
The information provided is factual to the best of my knowledqe, I under-
stand that I will be required to dqn a "S~at..ent of Economic Interests"
form as required by law, and that I will abide by all the code. and ordi-
nances of the city of San Bernardino and the state of California,
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I . lqnature ([ -...... ~, , Date