HomeMy WebLinkAbout01- Council Office 1.a
��tigNARp�No �
P
c ' Appointments
° a
City of San Bernardino
Request for Council Action r
G'�'4ED tN 10 N
0
v
Date: October 18, 2017
a�
L
To: Honorable Mayor and City Council Members
U
From: Mayor R. Carey Davis, Mayor
Bessine L. Richard, Ward Six Council
E
Subject: Appointment of Ms. Charle' Jacobs to the Parks & Recreation Q
Commission a
a
Recommendation That Ms. Charle' Jacobs be appointed to serve on the Parks & N
Recreation Commission, representing the Sixth Ward. A copy of Ms. Jacobs' application
is attached. °
E
E
• o
U
c
O
r
R
O
L
0
d
d'
o!f
N
L
a
as
s
0
0
v
m
L
l0
L
U
w
O
C
N
E
C
O
Q
Q
Q
r.+
C
O
E
V
a
Packet Pg. 11
This Page Is Left Intentionally Blank
1.b
C;11'`X OF SAM BERNAltl)INU"FLICA4 WN
FOR APPOINTMENT TO BOARDS, COUN USSIONS AND CONMTTEM
List,in order of preference,the committee(s)on which you wish to see.
1) / 3) avr
4)
2) – o
Nami'L cvl.ee 1 Date of Birch:
Home Address: Ci zip: d
i
Home Phone: E-Mail:'�-4.��a a�4�-1-� -CDS v
0
Employer: —_—��Z Q> Occupation: /<? �.
Address: City: Zip: c
° Years lived/worked in San Bernardino: " Work Phone:
a
Educational background/degrees 4'qe _-. - N
I am am not®a registered voter. Ward: � Marital Status:
a
Licenses or special
rates
m
Previous City of San Bernardino CommissionslCoMmittees: From/To: c
a
a
_ a
Organizations to which you belong(professional,technical,community): o
W The information provided is factual to the best of my knowledge. I understand that i may be requraed to
complete a Statement of Economic Inttxests Form as required by law, and that I will abide by all the codes, c
ordinances and regulations of the City of San Bernardino and the State of California. E
E
0
a4A CL
te
Signature a
0
Note: Applications will be Dept on file for a period of one(1)year. N
E
Return too Gigi dna!,City Clete,300 Ne"D" Street,San Bernardino,CA 9241001 E
0
U
0312212012—Pmpzrcd by rhe City G9Falc's office _
d
E
t
V
tC
fr
Q
Packet Pg. 12
4
This Page Is Left Intentionally Blank
I