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Application for Boards, Commissions, and Committees

  1. El Cerrito Office of City Clerk

  2. PERSONAL INFORMATION

    Please provide your name, residency and contact information.

  3. Length of Residence

  4. Owner/Tenant:

  5. Interest:*

  6. EMPLOYMENT

    Please provide current employer and occupation. Resumes are welcome but not required.

  7. EDUCATION AND EXPERIENCE:

    Share your education and experience, considering your activities in business, labor, professional, social, or other organizations; indicate relevant experience and abilities, including; and any prior experience with public agency boards, commissions, committees, taskforces, etc. which would help qualify you for appointment.

  8. REFERENCES

    Please list two personal or professional references, including name, address, and contact information.

  9. CONFLICTS OF INTEREST

    Please describe any possible personal or professional areas that may present a conflict of interest, or the appearance of conflict of interest, for serving on this board, commission or committee.

  10. ACKNOWLEDGEMENTS

    Please read and acknowledge the following statements regarding requirements to serve.

  11. I confirm that:

    1) The information submitted in this application is true and correct to the best of my knowledge; 2) I do not hold any other public office or position in the City; and 3) I AM A RESIDENT OF EL CERRITO and understand I must remain a resident for the duration of my service (unless otherwise provided in the Municipal Code), 3) I am aware of the meeting schedule for advisory bodies I am applying for and feel I will be able to devote the time necessary to perform the duties.

  12. By checking this box:*

  13. I understand that if appointed I am required to:

    1) File and OATH OF OFFICE; 2) File a Statement of Economic Interests Form 700 if I am appointed to the ARTS AND CULTURE COMMISSION, DESIGN REVIEW BOARD, FINANCIAL ADVISORY BOARD or PLANNING COMMISSION; 3) Complete Ethics Training if I am appointed to the ARTS AND CULTURE COMMISSION, DESIGN REVIEW BOARD, FINANCIAL ADVISORY BOARD, PARK AND RECREATION COMMISSION, OR PLANNING COMMISSION; 4) Complete a criminal records background check prior to service on the CRIME PREVENTION COMMITTEE.

  14. By checking this box:*

  15. By submitting my application I acknowledge and understand that:

    1)This application is a PUBLIC RECORD and will be disclosed in full upon request; and 2) Interviews regarding appointment, reappointment, or dismissal must be held in public and that the City Council cannot exercise any discretion in this matter.

  16. Leave This Blank:

  17. This field is not part of the form submission.