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HomeMy WebLinkAbout02.A- Mayor's Office 2.A DOC ID: 1374 CITY OF SAN BERNARDINO—REQUEST FOR COUNCIL ACTION Appointment From: Patrick J. Morris M/CC Meeting Date: 11/07/2011 Prepared by: Julie Frazier-Mathews, (909) 384-5133 Dept: Mayor's Office Ward(s): All Subject: Commission Appointment of Dena M. Peters to the Mobile Home Board (Neutral Representative) Financial Impact: No Cost to the City Motion: Approve appointment of Dena M. Peters to the Mobile Home Board (Neutral Representative), as requested by Mayor Morris. Synopsis of Previous Council Action: None BackLyround• Request Dena M. Peters be considered for appointment to serve on the Mobile Home Board (at the Council Meeting of November 7, 2011) Supporting Documents: Appointment of Dena M. Peters Mobile Home Board (PDF) Updated: 11/3/2011 by Mayra Ochiqui Packet Pg. 11 CITY OF SAN BERNARDINO APPLICA-TION,. FOR APPOINTMENT TO BOARDS, COMMISSJgNS AND COMMITTEES p List, in order of preference,the committee(s)on which you wish to serve(see list on reverse side). 3) -5�' Cdr �x 1 is m Q 2) t 4) _ Z Name: C"_. -' Date of Birth: �� 2 Home Address: , ° City Home Phone: ax: '?AO-1097 E-Mail: (`' i? , aom °0- Employer: Occupation: 4 Address: 470 � , �4 O � o City: p` 'nd Zip:? ��� o Years lived/worked in San Bernardino: Work Phone: - Educational background/degrees: &j �nrss m 4,a ex Q c I am am not[l a registered voter. Ward: - Marital Status: { Q Licenses or special certificates: M r Previous City of San Bernardino Commissions/Committees: From/To: m° t1�.► P E 0 Organizations to which you belong(professional, technical, community): o a The information provided is factual to the best of my knowledge. I understand that I may be required to complete a Statement of Economic Interests Form as required by law, and that I will abide by all the codes, o ordinances and regulations of the City of San Bernardino and the State of California. �- 0 d7jz — 6 0 Signature Date c a Note: Applications will be kept on file for a period of one (1)year. °- Q Return to: Rachel G. Clark,City Clerk,300 N. "D" Street, San Bernardino, CA 92418-0001 m E s 10/26/2001—Prepared by the City Clerk's Office v w Q Packet Pg. 12