Recreation Commission application — Fremont City Council, September 9, 2025

Board and Commission Application

Board or Commission you wish to serve on: _____________________________

(Planning Commission applicants: Please attach supplemental questionnaire)

Submit application to:

Office of the City Clerk
3300 Capitol Avenue, Building A
P.O. Box 5006
Fremont, CA 94537-5006

Personal Information:

Mr.
Mrs.
Ms.
Name: ______________________________________________________________________ Last First MI

Home Address: _ _______
Street City State Zip

Home Telephone: _ ____________ Work Telephone: _______________________

E-mail: _ ___________________ Fax:___________________________

Resident of the City of Fremont: ____________ 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) Gender:
□ Male □ Prefer to self-identify
□ Female □ Prefer not to say

Language(s) Spoken: _____________________

Background Information:

Why do you wish to serve as a member of this Board or Commission: ____________________

____________________________________________________________________________

What would you bring by way of perspective or experience to this Board or Commission: _____

____________________________________________________________________________

Employment/Volunteer Information:

Please list any qualifications you feel would provide positive input to the work of the commission.

Organization: _______________________________________ Dates: ____________________

Location: ________________________________ Position(s): __________________________

Responsibilities/accomplishments: ________________________________________________

____________________________________________________________________________

Organization: _______________________________________ Dates: ____________________

Location: ________________________________ Position(s): __________________________ Responsibilities/accomplishments: ________________________________________________