From: [email protected]
To: City Clerk
Subject: [External]Online Form Submittal: Commission / Committee Application Date: Thursday, October 10, 2024 2:23:46 PM
Message from external sender. Use Caution.
Commission / Committee Application
The City currently has two active Commissions/Committees: the Planning Commission and the Measure Z Citizen Committee. All commissions/committees consist of five members who shall not be officials or employees of the City. Applicants for the Planning Commission shall legally reside within the City limits or be the owner of a business that is established and currently licensed within the City limits (LEMC Section 2.24.020). Applicants for the Measure Z Citizen Committee must legally reside within the City limits. Each commission/committee serves as an advisory body to the City Council on policy matters or reviewing specific issues as directed by the City Council or prescribed by law. Currently, all Planning Commissioners are appointed at-large by a City Council Subcommittee. However, members of the Measure Z Citizen Committee are appointed by district by their elected council representative.
Instructions
Please answer each question completely. This application will be maintained until December 31st of each year. After December 31st, it is necessary to file a new application for another year of eligibility. Please be advised that the City Clerk's Department uses Voter Registration information for verification of residency. Note: This application is subject to the Public Records Act and may be released to the public.
Additional Resources to Assist in Completing Application View a map showing the City limits (PDF).
Find out which City Council District you live in.
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Commission / Committee
Applying For
Planning Commission, Measure Z Citizen Committee
Applicant Eligibility City Resident
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Applicant Information
First Name ISREAL
Last Name CEBALLOS
Address
City Lake Elsinore
State California
Zip Code 92530
Phone Number
Email Address
Length of Residency in
Lake Elsinore
4 years
Length in California 47 years
What City Council
District do you live in?
1 (Section Break)
Business Information (if Applicable)
Business Name Field not completed.
Business Type Field not completed.
Business Address Field not completed.
Lake Elsinore Business
License Number
Field not completed.
Expiration Date Field not completed.
Phone Number Field not completed.
Date Business
Established
Field not completed.
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Education Information
Name of School
Attended
San Bernardino Community College
City & State San Bernardino
Degree Earned Associate
Number of Units
Completed
80 Name of School
Attended
Crafton Hills Community College
City & State Yucaipa
Degree Earned Associate
Number of Units
Completed
12 Certificates Attained Criminal Justice
Philosophy
Religious Studies
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Do you have Economic
Interests, such as
income, investments,
real or personal property,
or outstanding loans
which might present a
potential conflict of
interest?
Yes
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Work History
Current Employer In Home Supportive Services
Address Field not completed.
Dates Worked 12/1/2008 - 10/10/2024
Position Caregiver
Duties Performed Assistance for Reciipient
Daily Living, Daily Chores
Cleaning and Running Errands for Recipient.
Previous Employer Field not completed.
Address Field not completed.
Dates Worked Field not completed.
Position Field not completed.
Duties Performed Field not completed.
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References
Preferably local residents or stakeholders who are qualified to comment on your capabilities
Name Maria Guadalupe Lopez
Address
Phone Number
Name
Field not completed.
Address Field not completed.
Phone Number Field not completed.
Name Field not completed.
Address Field not completed.
Phone Number Field not completed.
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Community Service Participation
Please describe types of service you have performed, if any.
Organization Measure Z Committee Member
Types of Service Responsibility of overseeing financial allocation of funds for distribution in our city of Lake Elsinore
Organization Concerned Citizens Of South Central Los Angeles Types of Service Assisting community leaders in outreaching local citizens to
assist in the betterment of the city and lowering crime and dilapidated properties in the city
Organization Los Ángeles Soccer League
Types of Service Assisted in the organization and development of soccer programs in the city of Los Angeles in order to better the community and involvement of kids in order to detour said kids from criminal activities through soccer..
Additional
Documentation
Field not completed.
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Are you an Officer or
Member of a policy-
making board of a non-
profit organization which
receives funding from
the City?
No
If Yes, please list all organizations.
Organization Field not completed.
Position Field not completed.
Organization Field not completed.
Position Field not completed.
Organization Field not completed.
Position Field not completed.
Additional Information Field not completed.
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Have you ever been
convicted of violating any
Federal, State, County or
Municipal law, regulation
or Ordinance, excluding
minor traffic violations?
No
If Yes, please explain. Field not completed.
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I would like to be a positive contributor for the betterment of our Why are you interested
in serving on this
Commission/Committee?
city and be intricate in making Lake Elsinore a safer and productive city for all its residents and visitors.
Please list any
qualifications you may
have to serve on the
Commission/Committee
you are applying for, i.e.
education, related
service or work
experience, budgeting or
financial experience,
community involvement,
etc.
Currently serving on the Measure Z Committee for District #1 (Section Break)
Please note
Appointees will be required to take an Oath of Office and file a completed Statement of Economic Interest form, if appointed to a position specified in the City’s Conflict of Interest Code. Appointees are not considered to be City employees for purposes of benefits, such as workers compensation and health insurance.
Applicant's Declaration and Signature
I certify under penalty of the perjury laws of the State of California that all information on this form is true and correct.
By typing my name and the
date completed on this form, I am affirming my intent to be a candidate for appointment to a Commission for the City of Lake Elsinore. If appointed I pledge to follow the laws of the City of Lake Elsinore, the policies as set forth by the City Council and to conduct myself in such a manner as to be a good representative of the City.
Signature (Please type
your name)
ISREAL CARLOS CEBALLOS
Date 10/10/2024
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