Select Commission
[Select]
Bicycle Advisory Commission
Building & Housing Board of Appeals
Climate Action Plan Ad-Hoc Advisory Committee
Downtown Steering Committee
Economic Development Advisory Committee
Highway 59/MLK Revitalization Strategy Ad-Hoc Adv
Measure C Citizen's Oversight Committee
Personnel Board
Planning Commission
Recreation & Parks Commission
Redevelopment Advisory Committee
Regional Airport Authority
Name
Home Address: (street,city,zip)
City:
Zip:
Mailing Address: (street,city,zip)
City:
Zip:
Home Telephone:
Cell Phone:
Email Address:
Place of Employment:
Occupation:
Work Address:
City:
Zip:
Work Telephone:
1a. Which area will you represent?
(REDEVELOPMENT ADVISORY COMMITTEE ONLY)
[Select]
Gateways Project Area
Project Area 2
1b. Which category applies to you?
(REDEVELOPMENT ADVISORY COMMITTEE ONLY)
[Select]
Business Owner
Business Tenant
Property Owner
Resident Owner
Resident Tenant
Name of Business/Organization:
Address of Business/Property:
City:
Zip:
Organization Representative:
Are you currently a registered professional?
(BUILDING & HOUSING BOARD ONLY)
Yes
1. Are you a QUALIFIED ELECTOR of Merced City? (Registered to vote in a City election.)
Yes
If yes, for how many years?
If no, do you live within the City's Sphere of Influence?
Yes
2. List past or present involvement in community-related activities (i.e., committees, volunteer work, commissions, boards, etc.)
3. State your understanding of the purposes, responsibilities, and services offered by the board, commission, or committee for which you are applying.
4. List any training, education, or experience that you feel would be advantageous to the board, commission, or committee.
5. State your reasons for submitting this application and what you expect to accomplish on this board, commission, or committee.
6. This space may be used for any other information you feel is pertinent.
7. List two references who can attest to your suitability for appointment to this board, commission, or committee.
Name:
Address:
City:
Zip:
Phone:
Name:
Address:
City:
Zip:
Phone:
8. If you are a member of any recognized bicycle organization, which one?
(BICYCLE ADVISORY COMMISSION ONLY)
9. By checking this box, I certify that I am the individual named in this application, and that all the information that I have provided is true and correct.