Edac tttonal Information:
Sun Jase 5-ufA MAST iZ t
irarH S rrn e j7g'
Educatio al ln.zztitwion Lkgree/ Diploran Fle Ytar
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Cal S a.- e - . s- 3 u 3At?+c-; o 1 1v s c q` 7- j
Educational hsstitution Ikgne/Dr`ploma Fteld Yeat
Add tional Inform tior( Please provlJe any other i»formatfan which youfeel woulai be erseful to the Ciry Counc! in reviewing,} u appticatian.)
Flease s gs and date yo t applteation and sab nit to tlie O, ct ojthe G3ity Clerk et the address below. rl, tm.... r''-/ a -. t
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Sygaadue pa
ParendGu d sn Sigeatttre( Reqtrlre,d,fnr Youtk rldvisory Candidutes orely) City Clerk
Cily of La throp
390 Towne Centre Drive
Lathrop, CA 95330
693
CtJNIlVII,SSIQN/ Ct NIll TTEE APPLICATIUN'
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SD REQM t'!.1l1l0{ 3i
Yoatli Advlaory Canrinasion: Mnst be a Lt6rap residcnt bdwocn 13 to L S years of a e ta aexve oa dus commission.
Se eior A
sory Canurtssteie: Must be a Lathrop resident SO yeacs of a e or averto en e an this commission.
PlanuP, Pnrk d Recre a Co f ows, s Meosrrne C pver r ht Co rre: Must be a Lathrop resideat to scrvc on this commissiaa
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Name: r
t e. 7 e.1a
Address• city:,, p Zip: i 5 3 3 C
Telephone( home}-. Telephone{ work)
Telephone( cellj Telephone( other)
E: Resident of the City of Lathrop: _ year;
Do you have Transpartation to attend the Commission meetings and Functians? Yes t C` No Back raand Infarmatiow:
are you retatCd co a cun t eity Employee No
If yes, give name aud relationship
EmpiaymeaWoivateer Iniorm tlon:
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orga» aotian tlate.
t 57 p7 5"` 5''- 1, r t-- r
On Pasitton{ s)
Respansibilities/ accomgtishments: w" t e. . k, . t,e t,. , t-, a-F S,. v'ro: Q.. r m /` i? 3 -- - t x''
s fi'.s.' S u/ a 4/ r T' 3 --"' r f Z. b 13
Orgatr o t Aate
5.- t-... C.. o. t'c.... Cov 1vTy Yi"k.,. o,rd ' t''- S'"-. n Pas& io( s)
Respoasibilitiesiaocomptishments:
694
Community Activities t6at yau have been involvad with( feel& ee ta aitach additional pages) N re ojOrga izatiac Posflfon/ Res stbfltttes Dates
NaareafOrganLtatron Pasilion/ Responsibillues/ Accamplishine rts Dalu Spectal Awarda ar RecagniHons yau 6ave received;
EdacxtMnal Informatioa:
t f 4Nc- c tt v' t.. Qtv q_? t— 1 c13
E'duc tianart Inslitutfon ikgree/Dlploma Fleld Year
c' f r't l' Cs.'+ ' C_ '" t-1 N1 , C7 t e t ac t 1 7 J '' I 7 Educatlonal Jnstttutlon DegredDiptomo F"ield Year
Addition l Informstion( Please provide arry other i f'orn atlon which yoa fee! w+outd 6e trseful ta the City Council in`°--` revlewin83' u aPPl ca#on.)
t ov, K. Wof% txl tiT" I'Ylw'' a>>` .+ rnnta.•!# y trt.t. 5, c. oS.*-- 3fb vJ•,d a.
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Plt tse slgn attd dateyoa apptira iio ared sabmit io the Uf,ice oftJre City Cler/r at the address below.. j —/ /—Zcs,.--
Si Datc
Pa t/Ciusrdian Signatwe{ Reaqwiradja Ymrtlt Adv3sory C.andtdates onty} City Clerk
City of Lathrop
39Q Towne Centre Dcive
Lathrop, CA 95330
695
696