APPLICATION FOR COUNCIL APPOINTMENT TO ADVISORY BODY
Revised 1/25/2021
Choose one; please complete a separate application for each advisory body for which you would like to be considered.
CONTACT INFORMATION
EDUCATION
High School Graduate; or
Location:
GED
College/University Major Degree/Date
CSU Sacramento Organizational Communication BA / 2008
Other formal education:
_ _ _
_ _
_ _
First Name: Kimberlyn Mailing
Last Name: Moffet
Address:
E-mail:
Phone:
Alt phone:
8741 Fehler Ln
[email protected]
925-457-4131
Advisory body to which appointment is sought:
✔
Planning Commission
Measure G Oversight Committee
Marin/Sonoma Mosquito & Vector Control District Other
This application is considered a public record pursuant to The California Public Records Act (Government Code 6520 et seq.) and may be made available to any member of the public upon request. Appointee’s contact information may be published in the City of Cotati public informational roster.
Appointees to certain advisory bodies will be required to complete a Statement of Economic Interest as required by California Government Code §87200 et seq. and the City of Cotati Conflict of Interest Code.
KM
Kimberlyn Moffet _ _ _
Application for appointment to advisory body
EMPLOYMENT HISTORY
List all employment during the last five years. If retired, list last employer.
Period Employer (include location) Position/Title
2018- Present Community Matters (Santa Rosa) Program & Training Manager 2016-2017 Stockton Teachers Association (Stockton) Membership Coordinator 2013-2016 St Mary's Dining Room (Stockton) Development Manager
PERSONALINFORMATION
Year you became a Cotati resident: _2019
Are you a City of Cotati registered voter? ✔ Yes No
Are you related to any member of the City Council, any City advisory body Member or City Employee? If yes, please list name and relationship:
Yes ✔ No
Are you currently a vendor or contractor with the City of Cotati Yes ✔ No Are you currently employed by the City of Cotati? Yes ✔ No
Have you ever been convicted of a felony? If yes, please explain: Yes ✔ No List civic activities, clubs, associations, etc.:
Rohnert Park Leadership Class 2, Measure S Oversight Committee, Sonoma County Equity in Education, _ _ _ United Flyers of Sonoma (General Member), Petaluma Mothers Club (General Member), Junior League of San Joaquin _ _ _
Briefly state your reasons for interest in the appointment sought:
I'm interested in being an informed and active participant in civic proceedings, promoting public interest in Cotati's general plan, _ _ _
and ensuring equitable land use ordinances that promote and support the diverse social economic population of Cotati. _ _ _
Please initial the following 2 paragraphs:
I understand that this application is considered a public record pursuant to The California Public Records Act (Government Code 6520 et seq.) and may be made available to any member of the public upon request. Appointee’s KM contact information may be published in the City of Cotati public informational roster.
I understand that appointees to certain advisory bodies will be required to complete a Statement of Economic Interest as required by California Government Code §87200 et seq. and the City of Cotati Conflict of Interest Code.
I certify that the foregoing is true and correct to the best of my knowledge:
Digitally signed by Kimberlyn Moffet
DN: cn=Kimberlyn Moffet, o=Community Matters, ou,
[email protected], c=US
Date: 2022.04.07 17:11:17 -07'00'
Signature Date
Emergency contact information (confidential; for emergency use only):
Ryan Moffet _ _ Name
Spouse 858-525-3366
Relationship Phone number
Thank you for your interest. Please return completed form to the 'HSXW\ City Clerk via email at NHSDWWHUVRQ#FRWDWLFLW\ RUg or deliever to City of Cotati, Attn.: Deputy City Clerk, 201West SierraAvenue, Cotati, CA 94931-4217 Y:\PROCEDURES SOPS\CMO Procdures SOPs\CITY CLERK PROCEDURES MANUAL\18.Advisory Bodies (City Commissions and Committees)\ADVISORY BODIES (Boards-Commissions etc.)\Application for Appointment to Advisory Body.docx