Section 1 of 8 in this document

City of Manhattan Beach

Application for Appointment to Boards and Commissions

Instructions:

Please read the Board and Commissions Handbook before completing this application

Application must be submitted on a yearly basis.
You must be a registered voter of the City of Manhattan Beach (unless you are applying for the a Business Community Representative).Complete the entire application.
Failure to respond to any question will make your application incomplete.
Please answer "none" or "not applicable" where appropriate.
Incorrect or false statements may cause rejection or dismissal.

For any questions, please contact the City Clerk's Office at (310) 802.5056.

IMPORTANT: Resumes or additional materials are optional. If you choose to include additional information, it must be submitted as part of this application and will be forwarded to the City Council for consideration.

Phone Number

Please check one:

Appointment

Reappointment

Are you a homeowner?

Yes

Are you a registered voter in the City of Manhattan Beach?

Yes

Are you a Manhattan Beach business owner?

Yes

Name of Manhattan Beach Business:

Section 2 of 8 in this document

Do you have any relatives currently employed by the City of Manhattan Beach?

Yes

If YES, please provide the name and relationship:

Have you ever, as an adult, been convicted of a crime?

Yes

If YES, please explain:

Section 3 of 8 in this document

Education

Name of High School:

Did you graduate?

Yes

Name of College and Degree:

Did you graduate?

Yes

Section 4 of 8 in this document

Employment

Are you currently employed?

Yes

If YES, please provide your job title:

Duties of your position:

Employer's name:

Do you have more than one current employer?

Yes

If YES, please provide your job title:

Duties of your position:

Employer's name:

Do you own or operate any business enterprises?

Yes

Name of business owned or operated:

Type of business or services rendered:

Have you ever been a registered lobbyist in the City of Manhattan Beach?

Yes

Please list any membership(s) in professional or civic organizations:

Section 5 of 8 in this document

Attendance

Please indicate when you can attend meetings (check more than one, if applicable):

Daytime

Evening

Are there any specific days or evenings you would not be able to attend meetings?

Yes

If YES, please list below:

Section 6 of 8 in this document

In order of preference, please select the board or commission for which you are applying.

Please note: Some seats have specific requirements such as Business Community Representative, Older Adult, Artist, etc. To be eligible for this seat, the applicant must meet the specified qualification.

(First Option) Please select one:

Briefly describe your interest and qualifications and experience related to the board or commission:

If appointed, please list three issues you think are the most important for your board or commission:

Please select a second option, if desired:

Briefly describe your interest and qualifications and experience related to the board or commission:

If appointed, please list three issues you think are the most important for your board or commission:

Please select a third option, if desired:

Briefly describe your interest and qualifications and experience related to the board or commission:

If appointed, please list three issues you think are the most important for your board or commission:

Please select a fourth option, if desired:

Briefly describe your interest and qualifications and experience related to the board or commission:

If appointed, please list three issues you think are the most important for your board or commission:

Section 7 of 8 in this document

Please describe any personal financial interests which may present a potential conflict of interest. Please be as specific as possible.

Resume (Optional)

Please download and certify below that you have read the Boards & Commissions Handbook.

I have read the Boards & Commissions Handbook.

Yes

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I declare under penalty of perjury under the laws of the state of California that the information in this form is true and complete.

City of Manhattan Beach

Application for Appointment to Boards and Commissions

Instructions:

Full Name

Address

Please check one:

Are you a homeowner?

Are you a registered voter in the City of Manhattan Beach?

Are you a Manhattan Beach business owner?

Manhattan Beach Business Address:

Do you have any relatives currently employed by the City of Manhattan Beach?

Have you ever, as an adult, been convicted of a crime?

Education

Did you graduate?

Did you graduate?

Employment

Are you currently employed?

Employers address:

Do you have more than one current employer?

Employers address:

Do you own or operate any business enterprises?

Address of business:

Have you ever been a registered lobbyist in the City of Manhattan Beach?

Attendance

Please indicate when you can attend meetings (check more than one, if applicable):

Are there any specific days or evenings you would not be able to attend meetings?

In order of preference, please select the board or commission for which you are applying.

Please note: Some seats have specific requirements such as Business Community Representative, Older Adult, Artist, etc. To be eligible for this seat, the applicant must meet the specified qualification.

Resume (Optional)

I have read the Boards & Commissions Handbook.

Sign Here