CITY OF MILPITAS COMMISSION/COMMITTEE APPLICATION
CITY OF MILPITAS COMMISSION/COMMITTEE APPLICATION
For residence of Milpitas, California ONLY.
COMMISSION/COMMITTEE APPLYING FOR:
*
Arts Commission
Community Advisory Commission
Economic Development and Trade Commission
Public Safety and Emergency Preparedness Commission
Energy and Environmental Sustainability Commission
Library and Education Commission
Parks, Recreation and Cultural Resources Commission
Planning Commission
Senior Advisory Commission
Science, Technology and Innovation Commission
Veterans Commission
Youth Advisory Commission
Measure F Oversight Committee
Name
Name
First
Middle
Last
Address Type
Address Type
Residence
Business
Address
City
Postal/Zip Code
Mobile Number
Mobile Number
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-
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####
E-Mail Address
*
Present Employer
Other Phone
Other Phone
-
###
-
###
####
Business Address (Optional)
City
Postal / Zip code
Occupation
Education: If Youth Advisory Commission applicant, indicate your grade/school:
College, Professional, Vocational, or other schools attended
Major Subject
Degree
List community organizations to which you belong or have belonged (additional information may be attached).
Name of Organization
Member
Name of Organization
Member
Name of Organization
Member
If application is for Veterans Commission, indicate branch and service in any U.S. military organization (retired or active duty).
Branch of Military
Officer
Briefly describe the personal qualifications you possess which you believe would be an asset (additional information may be attached):
Upload a File
Attach Files
Date
Date
/
MM
/
DD
YYYY
I have sufficient time to devote to this responsibility and will attend the required meetings if I am appointed to fill a future vacancy. I hereby certify that all statements contained in this application are true.
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
Appointments to Commissions or Committees are made by the Mayor with the concurrence of the City Council.
Applications not acted upon will expire after one year from the date submitted unless renewed by the applicant. Once submitted, your application will be submitted to the City Clerk.
NOTE: ALL COMMISSION APPLICATIONS ARE PUBLIC RECORD
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