APPLICATION to Committees/Commissions/Boards (“CCBs”)
Community Services Experience:
ORGANIZATION
From (date)
To (date)
OFFICES HELD
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Education:
SCHOOL
MAJOR
GRADUATION DATE/DEGREE
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Additional Pertinent Courses or Training:
Other Pertinent, Experience or Interests:
City of El Segundo Application to CCBs Part II
Please furnish brief, written responses to the questions below using additional sheets, if necessary:
1- Why do you think you should be appointed? What is there specifically in your background training, education and interests which qualifies you as a candidate?
2 - What do you see as the objectives/goals of the Committee(s)/Commission(s)/Board(s) you are applying to?
3 -How would you help achieve the objectives and goals?
4 - What reservations, if any, do you have about the Committee(s)/Commission(s)/Board(s)?
5 - Other comments:
6 - Please provide the names, addresses, and telephone numbers of three personal references (other than family members):
Name
Address
Phone
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Signature Date:
For further information call (310) 524-2302. You may fax your competed application to (310) 322-7137 or mail it to City Council, City of El Segundo, 350 Main Street, El Segundo, CA 90245-3895.
