Application for Appointment to a Citizen
Commission, Board, Committee, or Task Force
Acknowledgement
Applicants must be U.S. citizens, and residents and electors of the City of Huntington Beach during the appointment process and term, and may not hold more than one membership at a time.
Pursuant to the Municipal Code Chapter 2.100, no members of boards or commissions shall hold any paid office or employment in the City personnel system.
All Council appointed commission, board, and committee members are required to take two hours of AB1234 public service ethics training and AB1661 harassment prevention training every two years and thereafter.
All Council appointed commission, board, and committee members must comply with the City’s Huntington Beach Code of Ethics Policy, Social Media Policy for Elected and Appointed Officials (AR 509), Equal Employment Opportunity Policy (AR419), Anti-Harassment Policy (AR 412), and Workplace Violence Policy (AR 416).
You are applying for a public position. As such, the information provided in your application becomes a public record once the appointment process is completed, and may be subject to public inspection pursuant to the California Public Records Act.
If appointed, you will be required to take an Oath of Office and are subject to filling a Statement of Economic Interests pursuant to the City’s Conflict of Interest Policy (Resolution 2023-01).
Last Name* First Name* Middle Initial Date*
Name of Board, Commission, Committee, or Task Force*
Length of Residency in Huntington Beach*
Occupation*
United States Citizen?* Currently Serving on a City Board or Commission?*
Home Address:*
I acknowledge and certify that I meet the requirements listed in the notice above.
Carrick Kathy 1/27/2023
Mobile Home Advisory Board
45+ years
retired
Yes No
Yes No
City
Huntington Beach
State
California
Postal / Zip Code
92647
Street Address
Address Line 2
Phone Numbers
Personal
Type* (?) Number*
Phone Numbers
Business
Type (?) Number
Personal Email*
cell
Educational Background*
Professional Licenses and/or Associations*
Professional Experience*
Special Knowledge or Skills*
Civic Interests and/or Service Memberships?*
How will your qualifications best serve the citizen advisory group that you are applying for, and why do you wish to serve on this group?*
Signature*
It is the policy of the City Council to make appointments to the citizen commissions, boards, and committees, based on the needs of the city, as well as the interests and qualifications of each applicant. Selection will be made without discrimination based on the applicant's race, color, religion, ancestry, national origin, age, gender, sexual orientation, marital status, political affiliation, veterans’ status, disabilities, or any medical condition or any other basis protected by federal and state statutes.
All applications will remain active for one (1) year from the date received and be kept on file for 2 years for the position(s) applied for.
Additional information concerning a particular commission, board, committee, or task force or the application process is available through the staff support department identified above. General questions can be directed to Cathy Fikes, (714) 536-5553.
some college
none
Human Resources, Credential Analyst
none
Have been interested in local politics for several years. Often attend and speak at City Council and other board or committee meetings.
I consider myself to have a very strong work ethic and take pride in having common sense, the ability to think logically and a strong sense of integrity. Fairness and clarity are of utmost importance to me. I think these qualities are important for anyone wishing to serve in a public role and, particularly on the Mobil Home Advisory Board.
I certify that all statements made on this application are true and correct to the best of my knowledge. I have read and understand the duties and responsibilities of the particular position that I am applying for and authorize the release of this information.