Board and Commission Application
Apr 30, 2018
submission
#42
Application Form
Applicant Information
| Title | --- |
| Name | --- |
| Home Address | --- |
| What is your length of residence in Monrovia? Please indicate years and months. | --- |
| Cell Phone | --- |
| --- | |
| Employer | --- |
| Occupation | --- |
| Business Address | --- |
| Educational Background - Please describe any degrees obtained, licenses or special certificates held. | --- |
| Please list any organizations to which you belong (such as Professional, Technical, Civic, etc.). | --- |
| How did you learn about the Board and Commission vacancies? | --- |
Board and Commission Information
| Please check all of the boards or commissions to which you are interested in applying. | Planning Commission |
| Are you currently or have you ever been a member of any City board or commission? | No. |
| Why do you wish to serve, or continue to serve, on a board or commission? Why do you believe you are qualified to serve? | --- |
| What experience or special knowledge do you have pertaining to your area(s) of interest to serve? | --- |
| If selected, do you have adequate time available to serve? | --- |
| Resume (Optional) | --- |
| Other Attachments | --- |
MOTAB Supplemental Question
Are you applying to serve on MOTAB?
| Do you have a bona fide business in Old Town that is subject to business improvement district (BID) assessments? | --- |
Historic Preservation Commission Supplemental Questions
Are you applying to serve on the Historic Preservation Commission?
| Please indicate your professional experience in one or more of the following fields/disciplines. | History |
| Please describe your experience in the fields/disciplines you indicated above. | --- |
Certification
Certification - Please read before signing.
| Do you agree to the above statement? | --- |
City Review
Internal Review
| Application Received | --- |