CITY OF
Fremont
Board and Commission Application
Board or Commission you wish to serve on: MosQuITo. ABATEMENT (Planning Commission applicants: Please attach supplemental questionnaire) Submit application to:
Office of the City Clerk CITY CLERK
3300 Capitol Avenue, Building A
P.O. Box 5006 CONFIDENTIAL NOV 1 6 2023
Fremont, CA 94537-5006
CITY OF FREMONT
Personal Information:
Mr.
Mrs.
Ms.
Name: ZLATNIK JOHN
Last MI
Home Address:
Street City State ZIP
Home Telephone: Work Telephone:
E-mail: Fax:
Resident of the City of Fremont: f 45 _years
Demographic Information:
Ethnicity:
• American Indian or Alaskan Native • Chinese
• Black or African American & White
• Afghan • Vietnamese
• Mexican • Filipino
• Indian • Pakistani
• Other Asian origin: (write-in optional)
• Other African origin: (write-in optional)
• Other Hispanic, Latino, or Spanish origin: (write-in optional) -1-
Gender:
M Male • Prefer to self-identify
• Female • Prefer not to say
Language(s) Spoken:. English
Background Information:
why do you wish to serve as a member of this Board or Commission: i appledate The importara o mosquito control on public heath
What would you bring by way of perspective or experience to this Board or Commission: :
I worked sunnes with
a defereet Masquito Abalmet
Employment/Volunteer Information:
Please list any qualifications you feel would provide positive input to the work of the commission.
orenaton Washingten High School Dates: 1965-2001
Location: FREMONT CAL postions Teacher: Birdy, AP Bra
Responsibilitacompliments prepose, teach, a fall bag ourse Wth labs
organization: _ MU University Dates: 2010 - 2018
Location: San Francoco Positions): Feld Superusar
-2-
Respondinacomplatmans: Monitor & instruct beginnim
science tenders (primarily ecst bay Schools)
organeaton: Ms Colleg _Dates: 2001-2018
Location: Dal/and _ Posins field Super usa
Rosponsibiles/accomplishments: Monor & prouds instructan to pastica
Organization: _ Dates:
Location: Position(s):
Responsibilities/accomplishments:
Community Activities that you have been involved with (feel free to attach separate pages):
Tect Vaunters urmvan@administer 22013-2016
Name of Organization
Position/Responsibilities/Accomplishment
National Scitoum baten
Education
Education Information:
San Francisco Sfati BA physical Sci 11962
Educational Institution Degree/Diploma
Sau Jose State MA 1510 1971
Educational Institution Degree/Diploma Field Year
Additional Information (Please provide any other information which you feel would be useful to "name a varieto of expercences worky as
a group member in committees f problem
solving grays
a have a dog fascinatan for the sta
of natinal
Civic service is a privilege and responsibility of interested, qualified, sincere citizens. The value and importance of wide participation of a large number of citizens cannot be measured. Your interest in serving on a board or commission of the City of Fremont is greatly appreciated.
General Information: Your application is a public document and will be kept on file for one year.
If you would like additional information, please call the City Clerk's Office, at (510) 284-4060.
Please sign and date your application and submit to the Office of the City Clerk.
Saul. Jans 1/0423
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