CITY of COTATI
APPLICATION FOR COUNCIL APPOINTMENT TO ADVISORY BODY
Revised 10/2023
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 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.
Choose one; please complete a separate application for each advisory body for which you would like to be considered.
Advisory body to which appointment is sought:
•Planning Commission Measure S Oversight Committee
/ Library Commission Other
CONTACT INFORMATION
First Name: Tina Last Name: Poles
Mailing
Address: Cotati, CA 94931
E-mail:
Phone:
Alt phone:
EDUCATION
High School Graduate; or
Location:
GED Marian HS, Framingham, MA
College/University Major Degree/Date
University of California, Santa Cruz Biology BA-1990
Other formal education:
Diploma Of Waldorf Pedagogy, Center for Educational Renewal 2006 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
1997-2022 (retired) Sonoma Country Day School Science Teacher
PERSONAL INFORMATION
Year you became a Cotati resident: 2003
Are you a City of Cotati registered voter? •Yes No
Are you related to any member of the City Council, any City advisory body •Yes No Member or City Employee? If yes, please list name and relationship:
Are you currently a vendor or contractor with the City of Cotati •Yes Are you currently employed by the City of Cotati? •Yes ENo Have you ever been convicted of a felony? If yes, please explain: •Yes ENo List civic activities, clubs, associations, etc.:
Briefly state your reasons for interest in the appointment sought:
Atic maries roside free eucational resources to all which peomotes actly and inclusion have spent my le going to public iranies as a chid, homeowner, avid reader and teacher. I want to be able to support branes and stall as they contrue to adapt and en Please initial the following 2 paragraphs:
TMP
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 TMP 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 Tina Poles
Date: 2024.08 23 15:16:25 -0700 August 23, 2024
Signature Date
Emergency contact information (confidential; for emergency use only):
Richard Senghas Spouse
Name Relationship Phone number
Thank you for your interest. Please return completed form to the Deputy City Clerk via email at [email protected] or deliver to City of Cotati, Attn.: Deputy City Clerk, 201 West Sierra Avenue, Cotati, CA 94931-4217