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HomeMy WebLinkAboutAgenda Bill 4.A.Part3 03/07/2011SENIOR ADVIS.ORY COM:M'ITTEE ONE VACANCY TO COMPLETE AN UNEXPIRED TwO -YEAR TERM EXPIRING JUNE 30 2012 I� Moors, Paula Senior Advisory Committee C e t �e `�..�ue. o 'C f Petaluma, C'alaforn, ; City Board, Commission and Committee Ap ai Igg'8; .�° Instructions: Use this form to apply to serve on any Hof the City of Petaluma, Cali 's Boar s,. Co mmission s , or Please fill out the form completely. If a question does not a per 0 to N/A n t provid ded. When completed, .please forward to the City Clerk's Office Petaluma, I 1 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council. Name: Paula A Moors Home Address, City, State; and Zip Code: Petaluma, CA 94952 Home Phone: (If appointed, :do'you went this number.to be available to the ,public ?): Work Phone: ❑✓ YES ❑ NO ( ( E - Mail (if appoirifed, do you want this address to FAX: be avarlable,� �to fthe� ublic . public?) 0 YES NO ( _ Are you a registered voter in Petaluma? If so, for how. long? ®✓ YES ❑ NO 3 years Board(s); of Cbmm of Interest * : Animal Advisory commiftee Senior Advisory committee *Note: To, serve on the Senior Advisory Committee, you must be age 55 or above. Have you attended a ;meeting of4his Have you served on, interviewed, or applied for body? this body previously? D YES 0 N ® YES Z NO Moors, Paula Senior Advisory Committee C Present Employer: Old Adobe School / District (Part time) semi retired y Job Title: Campus aide and substitute for special needs children Previous Governmental Bodies /Elective Offices you have served, Position /Office Held and Dates: Civic or Charitable Organization io which -you have belonged,- Position /Office Held, and Dates: have worked for COTS as a volunteer What Special Interests /Skills/Talents would you bring to this Board, Commission,, or Committee? love animals and I think they need a voice. I am very computer literate and 1 have 22 years in property management. Page 2 of 4 I College, Professional `Vocational Schools Attended (Major Subject, Dates; Degree /Date): Special Awards or Recognition .Received: CBA (Certified Balloon Artist)" Please state reasons why you want to become a member of this.'Bo.ard, Commission or Committee, including what specific objectives you would be working toward as . a member of this advisory body: love Petaluma. I have lived here for 3 years and I would .like -to give back to my community and be more involved. Is there any.other that you feel would be, useful to the City Council in reviewing your application? Page 3 of 4 .Are, you associated with any Organization /Employment that might be deemed a conflict of interest'in your duties if appointed to this position? El YES ❑✓ NO If yes,.. please.state name of Organization /Employment: City policy directs all appointed ". advisory ,body.members not to vote. on matters where there. exists a potential conflict of interest. Would you be willing to abstain-from voting if such a conflict arises? YES El 'NO How did you hear about this opening? Petaluma Patch Applicant's Signature Date 2/22/20.1 Revised August 12, 2008 Page 4 of 4