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HomeMy WebLinkAbout2A-Mayor Z.A DOC ID: 2120 CITY OF SAN BERNARDINO—REQUEST FOR COUNCIL ACTION Appointment From: Patrick J. Morris M/CC Meeting Date: 12/03/2012 Prepared by: Raymond Lomeli, (909) 384- 5133 Dept: Mayor's Office Ward(s): Subject: Appointment of Judith Valles to the Board of Water Commissioners -Mayor Patrick J. Morris Financial Impact: N/A Motion: Approve the appointment of Judith Valles to the Board of Water Commissioners as requested by Mayor Patrick J. Morris. Synopsis of Previous Council Action: Background: Supporting Documents: Commission Appointment Judith Valles (PDF) Updated: 11/15/2012 by Georgeann"Gigi"Hanna I � PCk P" I 2.A.A CITY OF SAN BERNARDINO APPLICATION FOR APPOINTMENT TO BOARDS, COMMISSIONS AND COMMITTEES List, in or er of preference, the committee(s)on which you wish to serve (see list on reverse side). 1) 6' UCICf'(/ -a 3) to ° 2) 4) m US �� f� II�S Name: �LIG�(� �� U,� o Date of Birth: Cn Home Address: '? m Pa llte- r City: no Zip: t��Z1-(`/' > Home Phone: ( t )4'j_609z.7 Fax: ( ) .c E-Mail; !�j�1� i 'r4r) C i3vV1 Employer: 7 1 Occupation: ��� re_ Address: City: Zip: co Years lived/worked in San Bernardino: `7 0-4-- Work Phone: ( ) l/ 'Q Educational background/degrees: E>,A-- 1„_.-G a a I am [ am not U a registered voter. Ward: o Marital Status: A i ti N Licenses or special certificates: E 0 U o Previous City of San Bernardino Commissions/Committees: `" From/To: K, U) d ZS Organizations to which you belong(professional, technical, community): z c a> E 0 The information provided is factual to the best of my knowledge. I understand that I may be required to a complete a Statement of Economic Interests Form as required by law, and that I will abide by all the codes, c ordinances a d regulations of the City of San Bernardino and the State of California. o Signatur f/ ' cr- r. c)i2 E to Date c Note: Applications will be kept on file for a period of one(1) year. c a) Return to: Rachel G. Clark, City Clerk,300 N. "D" Street,San Bernardino,CA 92418-0001 0 .c 10/26/2001—Prepared by the City Clerk's Office Q I ; Packet Pg 0 I