ITEM 6. 2
CITY MANAGER' S REPORT
NOVEMBER 14, 2022 CITY COUNCIL REGULAR MEETING
ITEM: MAYOR' S REFERRAL
RECOMMENDATION: Appointment of Eight ( 8) Voting Members and One 1) Non- Voting Member to the Youth Advisory
Commission, with Terms Ending, May 31, 2023
YOUTH ADVISORY COMMISSION — LMC CHAPTER 2. 20
The commission currently has eight ( 8) available vacancies; nine ( 9) applications were received. The last application received will be placed as a non- voting member.
Tonight' s action, will complete the roster for the Youth Advisory Commission. Any new applications to join will be given the choice to be added as non- voting members.
APPLICANTS FOR CONSIDERATION:
1. Vaelua Vitale
2. Harnoor Brar
3. Daniel McCray
4. Gurjot Singh
5. Osen Ugbiyobo
6. Julissa Aguilar
7. Manpreet Kaur Bains
8. Christopher Cadiente
9. Carolina Padilla
CUMMISSION/ CC?MMITTEE APPLIC
Applying for: - Please Choose Fram The F ilawi Q
Speciat Rectulrements: AA($ qNp E( rR'( N
Ya tti Advisary Cam iissialr: Must be a Lathrop resident betwccn i 3 to 1$ years of age to servt ort this commission.
Sultor Advlsary Canlniission: Must be u Lathrop resident 50 years of age or over to serve on this cammissian.
Plaatring, Parks& Recreal7ou Commissfons, asd bteast re C Ovcrsight Ca nmittee: Must bc a Lathrop residcnt to serve on tl is commissian.
L.EASE PRINT QR TYPE THE FULLO VING INFORMATION:
Namc: — IC1'. 110.- `"... lcl_ P_-
Address: City: } eA Zip: Jy
Telephone{ homej elephane( work)
Telephone{ cell) elephone{ other)
Email: Resident of the City of Lathrop:_ years
Do you have Tr nspartt tion to attend the Commission mcetings And Functions? Yes No Background Information:
Ars you related ta a current City mployee? _
If yes, give name and relationship
EmploymenWolunteec Infurmation:
r. rc, . I u
rE a5 a t,rrs.-
organ ral, on are
I-, G rIl4 t'(,} l -Ll. c.' c lAiYi 5 0''
Location Positian(s)
Responsibilities/ accomplishments: _ Il c, t[ r r"- Ps,.[. r ( Afl,,, s, U1ia1n- G' Mc C. lu,.r... t i-H. - Ck r ar .
t' Gt,
4rgan. ar on Dote
Locatlon Posftlon( s)
Responsibi ti ties/ accomplishments:
Community Activities that yov have been invotved with( feel free to attach additional pages) Nante of Urganiza lon PositronlResporuibrlitres Dares
Nan e oJC) r,ganrtarton PasitiontResponxlbilttieslAccomptishntrnts Dates Spcc al Awards ar Recognitions yc u have reee[vcd:
I
t...ht c2 ^ Le.{ r"oP
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Educatianal I nfarmation:
r? r`
Eduratconal t 111t111OiI Dc rr ll iploma F Yenr
Educatiarral lrrstitrrtion Degree Diploma Field Year
Addittou l IrifoCm ttion ( Please provtde any otlrer injorr rutlolr tiiflric/ r yoii fe! woirtd be usefirl to rhe Cr'ty Council in revretiving you applicatio r.)
th,rtot. tl ,..' i. lcsu,li r( u thr .,_ t..+- C rit'_- of` -1--,,.; z, PL , .. t,. cxs t;v c... a--f t, . r..
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Ptease sign rnd date y+rr application and subluit tn N:e p ce afthe City Clerk at t/:e address below.. 1' 1 l 1 1 a`,.
S gnaturc ate
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ParendGua dia» Signature( Required fvr Yocuh Rdvisory Cundldutes onty) City Clerk
City oC athrop
390 Towne Centre Dr[ ve
Lathrop, CA 95330
COMMISSIONICOMM[ TTEE APPLICATION
Applying for: • Please Choose Frorn The Fol! g -
Zfr22
Saecial Rruuirctnents:
PARKS ANo RECREATlON i u h Idri q• Co nis. i n 1uxt t a Lnthn p rcsuicm bctHrcn 13 tu ! S yran uf agc to cr r un Ih s c mm. an Senivr aJ• t+orr Commi ion: fusl bc u Loithrvp rcsidcnt 50 y c: u1' c or u cr tu scn c cu tlua cnmmi icm Plnnain. P trks dc Rrcr nlir+n Cnrrtmic. inn. and. NrA.rarr C( hYrsi ht Can enine Atust hc n l.athn p rc. uirn i acn e un thi;« nucu..; iam.
L ASE NRIhT OR TYP TNF FOLLO i'lAC. 1NFAR tATiUti•
Namc:
Adc ress: City: %_.,,.........,._ Z P'
Trlcnc nc( ix mc) Tcicphonc{ ork)
Tricphc nr rcit TcEcphanc( othcr) ___., _..._.___.___._.___..___...._..._.__..__ . r>> Rcsidcnt of dic City of I.athr p: __ Z ycars
Da you ha c Trsns nrt tion to attcird thr Camm ss un mcct ngs and Functions? Ycs 10 Background Intormation:
Arc yc u rcl[ cd ta a currcnt City m laycc' __ y_
Ii°}es, b vc r amc and rel honshi _,. _.___,_.__.._.__ ._..___ __ _ .,....
Emplo mcnt/' oluntecr infarmatioe:
7r cur_ srl un
tl1e .._
LnCitttnn f'usrlio+t( rl
Rrsponsibiiittcs arcumplishmcnts:
Y ttlft, ultnlf ul'
Ia t linn fi c1tlriNlr)
Rcspons bit tics accamptishments:
Communit• Acti ities that yuu hati c bccn invol cd ith tfc l frcc tn attach additional rabcsi 1'a iu rJ' C) r,t, unr.unnn 1' r. c ria r/ R< Y/ x,ri., th lr» e D rfc unr. u/ Ur, uniru lun P rrhiu r'Rrc rrjnsth l ui c; Irc r nipl, Jtnre• n. r Uurr,• 5pecial t vurds or Rccognitions au hA c receired: iL ; i c ,
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Plra.rr i n and date} nt apptirutiu and xubmit ru 11re O cr ofth Cif}• C7erk at tite addresx hclor.. r. t#-- 1. 1. 0 5 naturc i,
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ParenUG tvn Stgnaturc( X yrilrctit j+,r}', r t/r: trl+v.f„- r C' un lr luir.c: e/) Cih Clerk
Cit• at L tbrnp
390 Towne Centrc Drn c
Lath ap. Ct 9; 3i0
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CUMMISSIUN/ COMMITTEE AFPLICATIUN
ApPlying for: b
Specisl RcQ utreiacnts:
yo rtli Advisory Cai, rmissian: Must bc a Lathrop resident between 13 to 18 years e t se`-ve a#this m ' .
Senlor ldvtsory Co raussivn: Must bc a Lothrap residcni 50 ycars ofagc or over to serve on this c P/aan/ ng. Parks Recteatian CotnarlssFo and Measure C Dvers ght Commrtt M Ii1 seruc on this commission.
PLEASE PRINT OR TYPE TEIE FOLLOWING INFORMATION•
4 Name• _ D 1 vt C1 ! T 1 , l..
Address City: 7 ' 11 t Zi : ' Q
Telep hone{ home) Telephone( work
Telephane cell Teiephone( other)
Email: Resident of the City of I.athrap: years
Do you have Transpartation ta attend the Commission meetings and Functions? Yes I Na I Background Information:
Are you related to a current City EmployeeT
If yes, give namc and retationship
EmploymentNo[unteer InformAtton:
Y
OrgQnLcrtion
Gocatian Pasition( s)
Responsibilitieslaccomp( ishments:
Org rizatian at
Lc cation Pasition( s)
Responsibilities faccamplishments:
t
r
w
ommunity Activ ties that you have been invotved with( feel free to attach Additional pa es) Namc of Orgasr atiar Positfan/ Rcsponslbilities Dutes
Nume ojOrganl: utJvit PasitionlResJx nstbillties!Arcc r» plisll rrenl.v tkrtes Spectat Awards or Recognttioas you have received: ! Y
Educutional Information:
l.-"C' 1n' 1 iChobt lc .
Edrrcarror: al tnstftutiore Oegree Diploma Fietd Year
F.duealionallnstitution DegrrcfDin/ vnra Fleld Year
Addlti0nal InformAtioti{ Please provide any otlrrr infarmc tian which voti feel wvr ld be irsejul ta the City Cot nci! i i revrewtng yar applicution.)
NQ 0 JYl^ ( ` - .£ 3{/ i 0 1 f
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Pltase sig i a rd daleyou aJplication aird subniit o the D ce fthe City Clerk at tlte address betow.. vt c t I. z
Si naturC I?atc
Pattn an Signature( Reyui for Yauth tdvLwr} Candidatcs only) City Clerk
City af Lathrop
390 Towne Centre Drive
Lathrap, CA 9533fl
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a CU1VIlViISSIUN/ COMMITTEE APPLICATI
a
App ng far: - Piease Choose From' fhe Fo!low ng- -,- ,,'; S, geial Reauirernents:
a
Youth Advisory Comm sion: Must be a Lat} uop resident betwcen t 3 to 18 years of age to serve on this cor sion:;; a SeaiorAdvisory Conrmission: Mast bi: a La hrop residcnt 50 years of age cu ovtr to serve on this comm cn PJunnPn g, Farks& Rerrealio» Commissians, arrd Measure C Oversight Cammittee: Must be a i.athrop i to se.,yc o this commission, C_ ' u¢.
I ASE PRINT(? R TYPE THE FOLLOWIN I IFORMAT ON:
Name:
Address: City:_ r; d_..._.._._. Zip: gS 3 0
Telephone( homej Telephone( work}
Telephone cetl) Telephone ( other)
Emaii: Resident af the City of Lathrop: years
Do you have Transpartadon to attend the Commission meetiags and F dons? Y es No Background Infarmatian:
re you related to a current City Employe 7
Ifyes, give name and relationship
EmploymentNolunteer Information:
S a' aa^ t Y- Dv Q,V Ytio,+;- p a -- } n
Qrgantzation pa
oC,(- tti t1D[ 1 t' 1 tf', K"
Locatton PasI ton( s)
Responsibilitieslaccomplishments: {,,''
trt r'
Drganlzarlon Dare
I.ocatinn Positivn( s)
Responsibilitieslaccomplishments:
Cammuniry Activities that you t ave bean invatved with( feel fr e to attach additionai pages) Ymne ojOrgantzatian Pastt on/Respanslbflitfes L ates
NQp78 OfOl A7f1201fO1t Position/ R sponsibr'litiesJ.4ccomplishnrents t?ates Speciaf Awards or Recogn tioas you 6ave received:
Educationat Informativnr
cL{ Yty t h-1 t rn k, r.bDl 1 it e t c 2.2 — 0 O
F.afucatiana Irutitutian Degree/ iplanra Field Year•
F..ducationa! Instituti n Degree/ Diploma Field Year
Additional Informutian ( Please provrde any ather inf rmatian which yc ufee! woeJd be rrsefrrl ta the City Catrncrl irr reviewing yau applicut on,)
Please stgn and date you app/ catiat und submit ta lhe O ce ofthe Ciry Clerk ut the vddress helow..
I zr 2..
Signature Date
7 C...-----'_"
Ptuent/ Guardian Sigtta ( Requiredfor Yauth Advisory eandida es anly) City Clerk
City aC Lathrop
39U Towt e Centre Drive
Lathrop, CA 9533
COMMISSIONlCUIVIMITTEE APPLICATION
Applying for:
Saccial Rearircmenb: 2 1L
Yoerrb Adrisary Conrnrhsran: Must be a Lathrop resident betwcen l3 to 1 S years of a NMpt f N Senror Aev sory Cau missron: Must be a Lathrop rcaidcnt SO ycaro of a c or ovcr to servc on this commissian.
Pl nnlM P rks d RerrMrNan Conu lsslons, and Messun C Ovaxlg t Ca wn+lae: Must be a Lalhrop residern o serve on thie commisiion.
PLEASE PR1NT OR TYPE T E FOLGOWING iNFORMAT101V•
Name:
Address: City: (,- r, rc n Zip:
Tcicphonc ome elephone( work}
Telephonc( ccll) elephonc( ather)
Emnil: Resident of the City of Lathrop:_ years
Da you have Transpoctation to attend the Commission meetings nd Functions? Yes No Backgronnd Information:
Are you cetated to A current City Employee? ( 1U .
lf yes, give name and relationship
EmpbymeotNoleenteer Information:
tr C 1 5' Uc C 1 n n
Organrzahoa Dafe
h ti YLocarion Positio s)
Responsibilities accomplishments: Y1 r
U - e '
n
Orgrrnizaliar pote
o
Locatton P sition( s)
Itesponsibilities/ accomptishments:
Community Activities that you have been involved wiih( feel free to attach additional pages) Nanie ojOrgani: ation Posi ionJRespoxsfbiliti s Datrs
NaneofOrgani a iori PositivnlRespo» sr"6flltres%,lccomplishments Dutes Specia[ Awards or Recognitions yau have received: 2,}' Z,.' 1. 1( r111 V e tv- U r 1 S Edacatioaal Iaforroation:
Edrrrationa! Instfn tian Degree.' D}ploma Fie1J Year
F.ducarionaJ!. rrtrurian Degrce/ 1) i 7orna Field eQi
Additional Informetioq( Plerrse provide any olher information vhirh you jeet wvuld be rrsefu! ta tlre City Co:rncil in revic+viag you application.)
YYl c 1 re2 - oor : 111 e P wttin y t C p W. t 1 v v—
v h 1 r
V r w w, 1rti
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Please sign and date yau applicatfon and subnrlt to t/ee OjJ3ce ojthe Ciry Clerk ut the address belaw. lo L.-
Signaturc Datc
a .
Parent/ Guardian Signaturc( Reqrrired jor Yourh AdvJsory Candidates only) City Clerk
City of Lathrop
390 Towne Ceatre Drive
Lathrop, CA 95330
COMMISSION/ COMMITTEE APPLICATION
AppIying for: p h pd.visorY ('prr w«,
Sacclnl RcAatrcmcna:
Youlb Advisory Coinnrlssion: Must be a Lathrop resident betwcen I3 to t 8 ycars of agc to scrve on this commission.
SeRlor AdvLsury Co anissioa: Must bc a Lathrop tesidmt 30}+aars ofage or ovtc to scrvc on this cammission. P/ annJ Parlts& this Reeremlcx Cen a fsstons, ond Measirre C Overslghl Co ae lttee: Must be e Lathrgp n sommissbn. 7G PLEASE PRINT OR TYPE' HE FOLLOWING INFURMATION {(; j 31 2 22 Namc: 1`SSc" ' t 12.r C 1"Y C#.ERK
Addrcss• City:, e3-} rop Zip: qJ 3
Telephone( home) Ttlephone( work)
Telephone ceU Tclephone( other)
E Resident of th City of Lathrop: years
Da you have Transportation to attend the Comrnissinn meetings and Functions? Yes No O Background informadon:
Are you related ta a current City Employee?
f yes, give name and relationship
EmploymentNolunteer Informat on:
11T 1' iC GT 2Q- 2,
Organt. allon
1 2.2 3 SG UO Y' 2Y
fe
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Position( s)
Responsibilities/ accomplisbments: C V j
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SU C a
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O he S s.w.r r d er 1 v
r rr sc ds
y -I. v e,vun s a p zn. a c F 2o+y - 20 20 Organiuttion Date
OSS C r fi't r-ti C '{; v r !' c- Lncatinn
Pnsition( s)
Responsibilities/ accompiishmtnts; + d iy v; 5 in n a jpp. s , yy y vt c! r
2.h»/ Ya D j t t.. L,..
Community Aciivities that you have becn iavolved with( feel free to attach additional pages) O r mtm i iv - zl a, za ? o 1
Nanu ojQrgani a ro i osi inn/ Responsi8ilrties Ilales
2 Nnme ojOrgan; atlal ParitionlRes tsonsibilities ircomptisJ me ls Dates Spec at Awards ar Recognitians you hsvc recejved: Yv C-n , 5 pp1 / Z J, c ,, a,, s ric.- 1 ec.o n i k,I S
or,.
Educat oaal Informatioa:
L iO i4' t . Up 5choo for £ x 20
Edircational' Instftut a
t e ree,,., p, nu Field Year
d ( 1,?a rall.+- i ' ows z-s 242Q-' Qr. s-}
Educationa! Inst Iion DegreefDfplarna Fietd 3ear
AddiNotlul InfoCmation( Please provide any other information vhich youjee! titi ould be useft l to the Ci1y Cauncil in reviex ing you application.)
21r1 CtJ 9' 1'!- t/ a IUYItor , 2 rroh , Co, G{ oo ahc aw. , nv Ive oC b
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v V' i ' l Q Q ' YNMN1 t ! ' MA' 1 r i iail M _ AN SY.IMPY' 7 Please s}gn and date you application and srrbniit 10 the O re ofthe City Clerk at the address below. 7 Signature Date
Paratt/Guardian Si re( Req ' for Youth Advisory Candidates only) City Clerk
City of Lathrap
39Q Towne Centre prive
L,athrop, CA 95330
RECEIVED
CITY OF LATHROP
CON[ MISSION/C4MMITTEE APPLICATIOl, } r
Applying for: V h 5or tiS WANCE DEPARTMENT
Speclal Rcodiremcnta:
Yanth Advisary Caa isslon: Musl be a i. throp tesident betwcen 13 to 18 years of agc Io serve on this cammission.
SenlarAdvlsary Coirrmisslaa: Must bo s Lathrop residp t SO years of agc or over to serve on this commission.
Plenni g Parks d Recnodon Cowuwlssfons, awd Mearuts C Ove aigbt Cemm rlte: Must be a Lathrop rrsident to servc on this commission.
PLEASE PRINT OR TYPE THE FOLLOWLNG INFORMATION•
Name: Ma r acee 1Co vr [ O lYl$
Address: Ciry: Zip.
Tetephone( home) I- II Teicphone( wark)
Teleph lephonc( other)
Email: Resideat of the Ciry of Lathtop:_ rj ye
Do you have Transportallon to attend the Cornmission meetings and Functions`I Yes [ a" No Background Iniormatiwt:
Are you related to a current City Employee? 1V(
f ycs, give name and rciationship
EmpbymentNolanteer Informstioa:
ci b a
f
u c-.
Organlsatron
Date
i- at n Sc,haol
to arto„
Position( s)
Responsibilitie accompGshments: Grea ked 1 s ci ed s a, w; s S q Wnp{ p v nO iVa ivnc i rrn Stc wQc or- . V
npciVileo, . d ,
l- S Cs a + ee n vb q 2022
Urganizalion
Date
h Ni h t
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Posflton( s)
Responsibititieslaccomplishments: _ R ecy eu 1 w15 o Y'o r1c CA rnoVC . 4p edvee ww e iv Q. nv roh,, ti
Commnnity Activities that you have been involved with( feel free to attach additional pages} 1t1
Name ofOrgani: a ion PosliianlResponsibiliries Dates
Nrime ojOrgan ution Posrtio u'Resporufbilitfesl tL•comptishments Dates Spectal Awards or RecogaiHons you have received: ' ` J o r 1Q, ( V V k . 8 ' Ou ih c In y
Educational Informstion:
1- 4 aP 1 q1rt Sc,hopi 1 StJlnaal di 1w N pt 202'
Eihrcatrarral lasnturion Degree/ DFploma Field Year
Edrrcalionu! Institu ion DegreeJDiplana Field Year
Additionsl IrifOrmation( Please provede any olher Injdrrnatio ivhich you feel woi ld be tseful to Jlte City Cottncr! In reviewing you applrration.)
r o be. tir oF L.a#h 'S ov h d bu
wv+v,n 5siw+ ar ot ve oac1 ao av,vnuv,- y• i . y,is
wu. td b e, c o' c ak tearv iY+r. rie.rtc a oll yqr. i Cv 41r- 1 t orw o h t k t e, Uen S . A i- ion 1
hove. read e . a,aivti. e
p, Cko ns av o l ha. tt
rv l r,i t h ot , o nn.P v kS
Please sign and da e
yau appllcah on and subne t to tke p ce ofthe City Clerk at the address below.. 10 3aJ Z,p' Z
Signature Datc
Par u
ian Signature( ltequfrcd or Youth ldvisory Candrda es only) City Clerk
City of Lathrop
390 Towoe Centre Drive
I,athrop, CA 95330
COMMISSIQN/ COMMITTEE APPLICATION
Applying for: __ ou1 i 1 vrt/ CoV' t ttsston
Special Reauirements:
Youth Advlsory Casmtss' on: Must be a Lathrop rcaident between 13 to I 8 years of age 10 serve on this commission.
Sen/ orAdvlsory CoNrmisstoa: Must bc a Lathrop resident 50 years of age or avcr to servc on this commission.
Ptunning P trk.c dc Recrearior Cenimissioris and Measun C Oversigh Conrmhtee: Must be a Lathrop resid ED this commission.
PLEASE PRINT OR TYPE THE FOLL4WING INFORMATION: NOV O4
Name:_" iy y>'LeV' GG' Jc: l^' Ca GGtr( et t. CiTY C. ERIC Address: City• Gt f't!' op Zip: q533 D
Telephone( l ome) Telephone( work)
Telephone( cell} Tcic hane( other)
Email: esidcnt ofthe City of Lathrop: j years
Do you have Transportation to uttend the Cornmission meetings and Functions? Yes No Backg aund Informallon:
Aze you related to a current City Employee? / UO
Ef yes, givc name and relationship
EmploymenWoluntcer Informatioa:
C G-t-e. vi Glub 0 9'/ 0 12Dz.2
Organisallon Dare
1.c hroto / iah i',l.aQ l
femhLocatioa Position{ s)
C rr a o! carn us -h Oick- u recyc/ ab/ es
Responsibilitieslaccomplishrnents: n y; yi, { „ ; j,,,,,,,,, A
v/`
Organ': ation Date
Lecatian Posltinn(s)
Respor sibi 1 iries/ aceomptishments:
Community Activities that you have been involved with{ fcel free to attach additianal pages} N
Name ojOr vni atiori PosilionlRc ponsihilrties Dates
Name of Organi utio: Posr"lionlResaonsibili iesr; ccomplishmen s Du es 5 Xz Speciai Awards or Recognitions you have received:_{ ,/- Q j. / yoy t ctyt C- Ir! y.O- L, v o Nla4sra rle F/ r,,e.u- r..-y / ic,cve 1 , L e I ac r f Gfti t/. me.u/- ; l3es i t,. 5a.. AG1ti<,vr.v»,o, Q-.
Edncationa! Informatian:
a.Hsrop l Q.. s hoo 14h I a. 2azs
drrcattonallnslu trnn Drgrrc` piptonta F1elJ Ysar
Educationallnsrltulion DegreelDiplana Field eQ
Addition8l Ipt'ormatlion( Please provide any vther rnjormation tivl ich you jee! iibutd be rrsejrllu the Ci1v Courrcil in reviewing yotl application.}
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t^. mmr; on. ts , rr rne hP.cnr,-i c- w,,., , - L,
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he 1 aru l klrtr,!- 4+.s!-tt ...1 . rsrh , u is alt, al/ s; L_ Xl/° n , T ,o i. P.t o! I Gl
x• r_nrn.,: __ i 1 Wrt h ,L. P C.r` I7mU' l i1 , —
Please sign and date yotr applicatian a»d sttbhrfl to the Offrce nfthe City Cle k at the address below.. s r -
ji/o/ px..
g Dpcc
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dGuardia gnaturo( Reqr,iredjar Youth Advisory Cai didates onl}) City Clerk
City of LAthrop
398 Towne Centre Drive
Lathrop, C,4 95330
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CC C MG
COMMISSI N/COMMITTEE A LIC. Q'
Applying for: KS
Saccial Rcauiremcnts:
You11i Advrsory Commissian: Must be a Lathrop resident between 13 to t8 years of age to serve on this commission.
Seuior Advisary Commission: Must be a Lathrop resident 50 years of age or over ta servc on this commission.
Planning, Parks& Recreation Conunissions, and Measure C Oversight Committee: Must be a Lathrop resident to serve on this commission.
PLEASE PRINT OR TYPE THE FOLLUWING INFORMATION:
Name:
Address: City: c. Qp Zip: ! "'
Telephone( home Teleptione ( work)
Telephone( ceI1) elephone( other
Email esident af the City of Lathrop: . L
years
Do you have Transportation to attend the Commission meetings and Functions? Yes 0 No Background Information:
Are you related to a current City Employee?
f yes, give name and relationship ,
EmploymeatNolunteer Information:
T
Organr ation a1e
Loc
n_n C.tt l Y t1:'
Posrlron( s)
Responsibilities/ accomplishments: p,M p• c e. e o
pT.
hh g _a.
x ; ons
io Q
Organization DAIp
1 1
Localion Po.si ion( s)
Responsibilities/ accomplishments: ' ' Y1 t
k
Community ActiviNes that you have been involved with( feel free to attach additional pages) GC a9 a 1
o c L S 53
a
t s
9 2oa`. - rtSeh hrop ,, r,n gr un L;nY, c e u m
Nanre of Organiz n FositiwcJResponsibilities Dates
Name ojOrganisation PositronlKesponsibilities/ Accomplishments Dates Special Awards or Recognitions you have received: e, eC P c 5 @M r O riS I (". S,P.,
Educational Information:
I 1 o . a
Edncationul lnstittuion Degree} Dip o Field Year
La i coo Uh x
c eci ' c rc, o—
Ed rafional nsrituti i Degree' Diploni Field ear
Addltjonal InfoCmation( Please provide any o her rijormatialr tivhich yotifeel tiro: ld be rsefii!! o the City Counci! in revie vingyocr applicat' on.)
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Please sig t and date yatr applicatio and sirbnrit to the Office oftlre City Clerk at the address below. o - -
Signature Date
ParendGuardian Reqt iredfor Yottlh Advisory Cmididutes only) City Clerk
City af Lathrop
390 Towne Centre Drive
Lathrop, CA 95330