Application for Appointment to a Citizen
CITP
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 (AR 921), Anti-Harassment, Discrimination, and Retaliation Policy (AR 922), Violence in the Workplace Policy (AR 923), and A Respectful Workplace Policy (AR 924).
• 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). • I acknowledge and certify that I meet the requirements listed in the notice above.
Prefix* Last Name* First Name* Middle Initial
Dr Meyer Christian D
Mr., Ms., etc.
Date *
3/5/2024
Name of Board, Commission, Committee, or Task Force *
City Celebration Committee
Length of Residency in Huntington Beach*
9 years
Occupation*
Forensic Psychologist
United States Citizen?* Currently Serving on a City Board or Commission?*
• Yes • No
• Yes • No
Home Address:*
Street Address
Address Line 2
City State
Huntington Beach CA
Postal / Zip Code
92649
Phone Numbers Phone Numbers
Personal Business
Type * (?) Number* Type (?) Number
cell
Personal Email*
Educational Background*
Bachelor of Arts - Psychology
Master of Science - Clinical Psychology
Master of Arts - Forensic Psychology
Doctorate - Clinical Forensic Psychology
Professional Licenses and/or Associations *
CA Psychological License - PSY26044
Professional Experience *
20 years working in in-patient locked psychiatric hospitals.
Special Knowledge or Skills *
Clinical Psychology
Forensic Psychology
Crisis intervention
Hostage negotiation
Civic Interests and/or Service Memberships?*
Civic interests - anything to serve HB and maintain Patriotism and history.
No current 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?*
My qualifications have taught me to work with an interdisciplinary team and to listen and consider all members input. I wish to serve on this group to keep the history of HB alive and incorporate the Patriotism, values, and culture in our city's celebration.
J 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.
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, ancestry, national origin, religion, creed, age (40 and over), physical and/or mental disability, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, military or veteran status, any other category/status protected by federal and/or 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.