Neither the issuer of the Bonds ( the " Issuer") nor the trustee or any paying agent appointed with respect to the Bonds ( the " Agent') take any responsibility for the information contained in this Appendix.
No assurances can be given that DTC, DTC Participants or Indirect Participants will distribute to the Beneficial Owners ( a) payments of interest, principal or premium, if any, with respect to the Bonds, ( b) certificates representing ownership interest in or other confirmation or ownership interest in the Bonds, or( c) redemption or other notices sent to DTC or Cede & Co., its nominee, as the registered owner of the Bonds, or that they will so do on a timely basis, or that DTC, DTC Participants or DTC Indirect Participants will act in the manner described in this Appendix. The current " Rules" applicable to DTC are on file with the Securities and Exchange Commission and the current " Procedures" of DTC to be followed in dealing with DTC Participants are on file with DTC.
1. The Depository Trust Company (" DTC"), New York, NY, will act as securities depository for the securities ( the " Securities"). The Securities will be issued as fully- registered securities registered in the name of Cede & Co. ( DTC' s partnership nominee) or such other name as may be requested by an authorized representative of DTC. One fully-registered Security certificate will be issued for each issue of the Securities, each in the aggregate principal amount of such issue, and will be deposited with DTC. If, however, the aggregate principal amount of any issue exceeds $ 500 million, one certificate will be issued with respect to each $ 500 million of principal amount, and an additional certificate will be issued with respect to any remaining principal amount of such issue.
2. DTC, the world' s largest securities depository, is a limited- purpose trust company organized under the New York Banking Law, a " banking organization" within the meaning of the New York Banking Law, a member of the Federal Reserve System, a " clearing corporation" within the meaning of the New York Uniform Commercial Code, and a " clearing agency" registered pursuant to the provisions of Section 17A of the Securities Exchange Act of 1934.
DTC holds and provides asset servicing for over 3. 5 million issues of U. S. and non- U. S. equity issues, corporate and municipal debt issues, and money market instruments ( from over 100 countries) that DTC' s participants (" Direct Participants") deposit with DTC. DTC also facilitates the post- trade settlement among Direct Participants of sales and other securities transactions in deposited securities, through electronic computerized book-entry transfers and pledges between Direct Participants' accounts. This eliminates the need for physical movement of securities certificates. Direct Participants include both U. S. and non- U. S. securities brokers and G- 1
1324
dealers, banks, trust companies, clearing corporations, and certain other organizations. DTC is a wholly- owned subsidiary of The Depository Trust 8 Clearing Corporation (" DTCC"). DTCC is the holding company for DTC, National Securities Clearing Corporation and Fixed Income Clearing Corporation, all of which are registered clearing agencies. DTCC is owned by the users of its regulated subsidiaries. Access to the DTC system is also available to others such as both U. S. and non- U. S. securities brokers and dealers, banks, trust companies, and clearing corporations that clear through or maintain a custodial relationship with a Direct Participant, either directly or indirectly (" Indirect Participants"). DTC has a Standard & Poor' s rating of AA+.
The DTC Rules applicable to its Participants are on file with the Securities and Exchange Commission. More information about DTC can be found at www. dtcc. com.
3. Purchases of Securities under the DTC system must be made by or through Direct Participants, which will receive a credit for the Securities on DTC' s records. The ownership interest of each actual purchaser of each Security (" Beneficial Owner") is in turn to be recorded on the Direct and Indirect Participants' records. Beneficial Owners will not receive written confirmation from DTC of their purchase. Beneficial Owners are, however, expected to receive written confirmations providing details of the transaction, as well as periodic statements of their holdings, from the Direct or Indirect Participant through which the Beneficial Owner entered into the transaction. Transfers of ownership interests in the Securities are to be accomplished by entries made on the books of Direct and Indirect Participants acting on behalf of Beneficial Owners. Beneficial Owners will not receive certificates representing their ownership interests in Securities, except in the event that use of the book-entry system for the Securities is discontinued.
4. To facilitate subsequent transfers, all Securities deposited by Direct Participants with DTC are registered in the name of DTC' s partnership nominee, Cede & Co., or such other name as may be requested by an authorized representative of DTC. The deposit of Securities with DTC and their registration in the name of Cede & Co. or such other DTC nominee do not effect any change in beneficial ownership. DTC has no knowledge of the actual Beneficial Owners of the Securities; DTC' s records reflect only the identity of the Direct Participants to whose accounts such Securities are credited, which may or may not be the Beneficial Owners. The Direct and Indirect Participants will remain responsible for keeping account of their holdings on behalf of their customers.
5. Conveyance of notices and other communications by DTC to Direct Participants, by Direct Participants to Indirect Participants, and by Direct Participants and Indirect Participants to Beneficial Owners will be governed by arrangements among them, subject to any statutory or regulatory requirements as may be in effect from time to time. Beneficial Owners of Securities may wish to take certain steps to augment the transmission to them of notices of significant events with respect to the Securities, such as redemptions, tenders, defaults, and proposed amendments to the Security documents. For example, Beneficial Owners of Securities may wish to ascertain that the nominee holding the Securities for their benefit has agreed to obtain and transmit notices to Beneficial Owners. In the alternative, Beneficial Owners may wish to provide their names and addresses to the registrar and request that copies of notices be provided directly to them.
6. Redemption notices shall be sent to DTC. If less than all of the Securities within an issue are being redeemed, DTC' s practice is to determine by lot the amount of the interest of each Direct Participant in such issue to be redeemed.
G- 2
1325
7. Neither DTC nor Cede & Co. ( nor any other DTC nominee) will consent or vote with respect to Securities unless authorized by a Direct Participant in accordance with DTC' s MMI Procedures. Under its usual procedures, DTC mails an Omnibus Proxy to Issuer as soon as possible after the record date. The Omnibus Proxy assigns Cede & Co.' s consenting or voting rights to those Direct Participants to whose accounts Securities are credited on the record date identified in a listing attached to the Omnibus Proxy).
8. Redemption proceeds, distributions, and dividend payments on the Securities will be made to Cede 8 Co., or such other nominee as may be requested by an authorized representative of DTC. DTC' s practice is to credit Direct Participants' accounts upon DTC' s receipt of funds and corresponding detail information from Issuer or Agent, on payable date in accordance with their respective holdings shown on DTC' s records. Payments by Participants to Beneficial Owners will be governed by standing instructions and customary practices, as is the case with securities held for the accounts of customers in bearer form or registered in " street name," and will be the responsibility of such Participant and not of DTC, Agent, or Issuer, subject to any statutory or regulatory requirements as may be in effect from time to time.
Payment of redemption proceeds, distributions, and dividend payments to Cede & Co. ( or such other nominee as may be requested by an authorized representative of DTC) is the responsibility of Issuer or Agent, disbursement of such payments to Direct Participants will be the responsibility of DTC, and disbursement of such payments to the Beneficial Owners will be the responsibility of Direct and Indirect Participants.
9. DTC may discontinue providing its services as depository with respect to the Securities at any time by giving reasonable notice to Issuer or Agent. Under such circumstances, in the event that a successor depository is not obtained, Security certificates are required to be printed and delivered.
10. Issuer may decide to discontinue use of the system of book- entry- only transfers through DTC ( or a successor securities depository). In that event, Security certificates will be printed and delivered to DTC.
11. The information in this section concerning DTC and DTC' s book-entry system has been obtained from sources that Issuer believes to be reliable, but Issuer takes no responsibility for the accuracy thereof.
G- 3
1326
APPENDIX H
SPECIMEN MUNICIPAL BOND INSURANCE POLICY
G- 1
1327
GOOD FAITH ESTIMATES
The good faith estimates set forth herein are provided with respect to the Bonds in compliance with Section 5852. 1 of the California Government Code.
Such good faith estimates have been provided to the City Council of the City of Lathrop by KNN Public Finance, LLC, as municipal advisor ( the Municipal Advisor").
Principal Amount. The Municipal Advisor has informed the City that, based on the City' s financing plan and current market conditions, their good faith estimate of the aggregate principal amount of the Bonds to be sold is $ 10. 7 million the " Estimated Principal Amount").
True Interest Cost of the Bonds. The Municipal Advisor has informed the City that, assuming that the Estimated Principal Amount of the Bonds is sold and based on market interest rates prevailing at the time of preparation of such estimate, their good faith estimate of the true interest cost of the Bonds, which means the rate necessary to discount the amounts payable on the respective principal and interest payment dates to the purchase price received for the Bonds, is 3. 50%.
Finance Charge of the Bonds. The Municipal Advisor has informed the City that, assuming that the Estimated Principal Amount of the Bonds is sold and based on market interest rates prevailing at the time of preparation of such estimate, their good faith estimate of the finance charge for the Bonds, which means the sum of all fees and charges paid to third parties ( or costs associated with the Bonds), is 630, 000.
Amount of Proceeds to be Received. The Municipal Advisor has informed the City that, assuming that the Estimated Principal Amount of the Bonds is sold and based on market interest rates prevailing at the time of preparation of such estimate, their good faith estimate of the amount of proceeds expected to be received by the City for sale of the Bonds, less the finance charge of the Bonds, as estimated above, and any reserves or capitalized interest paid or funded with proceeds of the Bonds, is $ 10. 1 million.
Total Payment Amount. The Municipal Advisor has informed the City that, assuming that the Estimated Principal Amount of the Bonds is sold, and based on market interest rates prevailing at the time of preparation of such estimate, their good faith estimate of the total payment amount, which means the sum total of all payments the Agency will make to pay debt service on the Bonds, plus the finance charge for the Bonds, as described above, not paid with the proceeds of the Bonds, calculated to the final maturity of the Bonds, is $ 14. 2 million.
The foregoing estimates constitute good faith estimates only. The actual principal amount of the Bonds issued and sold, the true interest cost thereof, the finance charges thereof, the amount of proceeds received therefrom and total payment amount with respect thereto may differ from such good faith estimates due to ( a) the actual date of the sale of the Bonds being different than the date assumed for purposes of such estimates, ( b) the actual principal amount of Bonds sold being Attachment K"
1328
different from the Estimated Principal Amount, ( c) the actual amortization of the Bonds being different than the amortization assumed for purposes of such estimates, d) the actual market interest rates and yields at the time of sale of the Bonds being different than those estimated for purposes of such estimates, ( e) other market conditions, or ( f) alterations in the City' s financing plan, or a combination of such factors. The actual date of sale of the Bonds and the actual principal amount of Bonds sold will be determined by the City based on the need for funds to pay the principal and interest due on the bonds being refunded, available funds on hand and other factors, such as the interest rates on and reoffering prices for the refunding bonds.
The actual interest rates on and reoffering prices for the Bonds will depend on market conditions at the time of sale thereof. The actual amortization of the Bonds will also depend, in part, on market interest rates at the time of sale thereof. Market interest rates and yields are affected by economic and other factors beyond the control of the City.
1329
ITEM 5. 2
CITY MANAGER' S REPORT
MAY 8, 2023 CITY COUNCIL REGULAR MEETING
ITEM: REVIEW AND PROVIDE DIRECTION ON DESIGN
OPTIONS FOR CIP PK 22- 12 THE GREEN PARK
REVITALIZATION
RECOMMENDATION: Approve a Resolution For The Design Option For CIP PK 22- 12 The Green Park
Revitalization.
SUMMARY:
At the June 3, 2021 City Council Meeting, Council approved the creation of Capital Improvement Project ( CIP) PK 22- 12, The Green Park Revitalization ( the Project).
Staff has three design concepts for Council review. Upon review, staff requests Council provide direction on approval of one of the three design options to allow staff to move forward with the Project.
BACKGROUND:
At the June 3, 2021 City Council meeting, Council approved the creation of Capital Improvement Project ( CIP) PK 22- 12, The Green Park Revitalization. The Green Park is a 1- acre park bordered by Victorian Trail and English Country Trail within the Mossdale Landing development. This park site currently includes a small train themed tot- lot play area, which is close to 20 years old. The current play structure and amenities are designed for use by children ages 3- 5, which does not meet the needs of the entire community. This project would propose the removal of the existing play structure and the installation of a larger play structure designed for children up to 12 years of age. Due to the small footprint of the current play structure, the park will have to be redesigned to accommodate the placement of the new larger structures.
RECOMMENDATION:
Tonight, staff is asking Council to review these three options and provide staff direction with which option to move forward with.
1330
CITY MANAGER' S REPORT
MAY 8, 2023 CITY COUNCIL REGULAR MEETING
REVIEW AND PROVIDE DIRECTION ON DESIGN OPTIONS FOR PK 22- 12
THE GREEN PARK REVITALIZATION
Option 1 — The Green Park Revitalization
This option will include the removal of items mentioned above as well as the addition of the following amenities:
Children' s Play Area ages 5- 12 One Overhead Traverse Three NFuse Bays Three Overhead Shade Sails One Nimble Bay Bridge 13 Climbers 11 Elevated Play Events 11 Ground Level Play Events Three Slides The option 1 design is an extensive redesign of the existing 1- acre park site including the installation of a children' s play area with a material and installation total estimated cost of $ 681, 770.
Option 2 — The Green Park Revitalization
This option will include the removal of items mentioned above as well as the addition of the following amenities:
Children' s Play Area ages 5- 12 One Nimble Bay Bridge Two Slides Two Crawl- Netix Climbers Five Climbers Four NFuse Bays 11 Elevates Play Events 11 Ground Level Play Events
The option 2 design is an extensive redesign of the existing 1- acre park site including the installation of a children' s play area with a material and installation total estimated cost of $ 505, 406.
Option 3 — The Green Park Revitalization
This option will include the removal of items mentioned above as well as the addition of the following amenities:
Children' s Play Area ages 5- 12 One Plastic Hex Shade Three Slides Two Crawl- Netix Climbers 12 Elevated Play Events One XM Tower Nine Ground Level Events
The option 3 design is an extensive redesign of the existing 1- acre park site including the installation of a children' s play area with a material and installation total estimated cost of $ 529, 861.
1331
CITY MANAGER' S REPORT
MAY 8, 2023 CITY COUNCIL REGULAR MEETING
REVIEW AND PROVIDE DIRECTION ON DESIGN OPTIONS FOR PK 22- 12
THE GREEN PARK REVITALIZATION
FISCAL IMPACT:
As part of the Fiscal Year 21- 22 budget, CIP PK 22- 12 The Green Park Revitalization was approved with a budget of $ 255, 000. Depending on the option selected by City Council, the corresponding funds will then be determined and requested within the upcoming budget hearings.
ATTAC H M E NTS:
A. Resolution to approve design option for CIP PK 22- 12 The Green Park Revitalization.
B. Capital Improvement Project Plan Project Number PK 22- 12, The Green Park Improvements.
1332
CITY MANAGER' S REPORT
MAY 8, 2023 CITY COUNCIL REGULAR MEETING
REVIEW AND PROVIDE DIRECTION ON DESIGN OPTIONS FOR PK 22- 12
THE GREEN PARK REVITALIZATION
APPROVALS:
S'. 2.._ zc 2,3
Tod Sebastian Date
Director of Parks, Recreation,
and Maintenance Services
3 73
Cari Ja s Date
Direct of Finance
S- 3- Zoz3
Michael King Date
Assistant City Manager
S /— Z.p Z 3
Salvador Navarrete Date
City Attorney
i 3 •Z3
Stephen J. Salvatore Date
City Manager
1333
RESOLUTION NO. 23-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF LATHROP APPROVING THE DESIGN OPTION FOR CIP PK 22- 12 THE GREEN PARK REVITALIZATION.
WHEREAS, at the June 3, 2021 City Council meeting, Council approved the creation of Capital Improvement Project ( CIP) PK 22- 12, The Green Park Revitalization; and
WHEREAS, the Green Park is a 1- acre park bordered by Victorian Trail and English Country Trail within the Mossdale Landing development; and WHEREAS, the current play structure and amenities are designed for use by children ages 3- 5, which does not meet the needs of the entire community; and WHEREAS, this project would propose the removal of the existing play structure and the installation of a larger play structure designed for children up to 12 years of age; and
WHEREAS, City Council reviewed and considered design options for Capital Improvement Project ( CIP) PK 22- 12 The Green Park Revitalization and selected Option 1; and
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop approves design Option 1 as detailed in the City Manager Report that accompanied this Resolution for CIP PK 22- 12.
1334
The foregoing resolution was passed and adopted this 8T" day of May 2023, by the following vote of:
AYES:
NOES:
ABSTAIN:
ABSENT:
Sonny Dhaliwal, Mayor
ATTEST: APPROVED AS T FORM:
Teresa Vargas, City Clerk Salvador Navarrete, City Attorney 1335
RESOLUTION NO. 23-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF LATHROP APPROVING THE DESIGN OPTION FOR CIP PK 22- 12 THE GREEN PARK REVITALIZATION.
WHEREAS, at the June 3, 2021 City Council meeting, Council approved the creation of Capital Improvement Project ( CIP) PK 22- 12, The Green Park Revitalization; and
WHEREAS, the Green Park is a 1- acre park bordered by Victorian Trail and English Country Trail within the Mossdale Landing development; and WHEREAS, the current play structure and amenities are designed for use by children ages 3- 5, which does not meet the needs of the entire community; and WHEREAS, this project would propose the removal of the existing play structure and the installation of a larger play structure designed for children up to 12 years of age; and
WHEREAS, City Council reviewed and considered design options for Capital Improvement Project ( CIP) PK 22- 12 The Green Park Revitalization and selected Option 2; and
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop approves design Option 2 as detailed in the City Manager Report that accompanied this Resolution for CIP PK 22- 12.
1336
The foregoing resolution was passed and adopted this 8T" day of May 2023, by the following vote of:
AYES:
NOES:
ABSTAIN:
ABSENT:
Sonny Dhaliwal, Mayor
ATTEST: APPROVED AS TO ORM:
Teresa Vargas, City Clerk Salvador Navarrete, City Attorney 1337
RESOLUTION NO. 23-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF LATHROP APPROVING THE DESIGN OPTION FOR CIP PK 22- 12 THE GREEN PARK REVITALIZATION.
WHEREAS, at the June 3, 2021 City Council meeting, Council approved the creation of Capital Improvement Project ( CIP) PK 22- 12, The Green Park Revitalization; and
WHEREAS, the Green Park is a 1- acre park bordered by Victorian Trail and English Country Trail within the Mossdale Landing development; and WHEREAS, the current play structure and amenities are designed for use by children ages 3- 5, which does not meet the needs of the entire community; and WHEREAS, this project would propose the removal of the existing play structure and the installation of a larger play structure designed for children up to 12 years of age; and
WHEREAS, City Council reviewed and considered design options for Capital Improvement Project ( CIP) PK 22- 12 The Green Park Revitalization and selected Option 3; and
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop approves design Option 3 as detailed in the City Manager Report that accompanied this Resolution for CIP PK 22- 12.
1338
The foregoing resolution was passed and adopted this 8T" day of May 2023, by the following vote of:
AYES:
NOES:
ABSTAIN:
ABSENT:
Sonny Dhaliwal, Mayor
ATTEST: APPROVED AS T FORM:
Teresa Vargas, City Clerk Salvador Navarrete, City Attorney 1339
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1341
ITEM 6. 1
CITY MANAGER' S REPORT
MAY 8, 2023 CITY COUNCIL REGULAR MEETING
ITEM: MAYOR' S REFERRAL
RECOMMENDATION: Appoint Ten of Thirteen ( 10 of 13) Members to the Youth Advisory Commission with Term Expiring May
31, 2024
YOUTH ADVISORY COMMISSION — LMC CHAPTER 2. 20
The commission will have Thirteen ( 13) available vacancies; Ten ( 10) applications were received. Staff will continue to recruit until all vacancies are filled.
Former Date of Reappointment Term Expiration
Commissioner( s); Appointment Date Date
Daniel Manzanares Jr. 9/ 12/ 22 n/ a 5/ 31/ 23
Pranav Vemparala 7/ 12/ 21 9/ 12/ 22 5/ 31/ 23
Angelina Michelucci 9/ 12/ 22 n/ a 5/ 31/ 23
Amani Watson 9/ 12/ 22 n/ a 5/ 31/ 23
Bradley Hurlburt 10/ 10/ 22 n/ a 5/ 31/ 23
Vaelua Vitale 11/ 14/ 22 n/ a 5/ 31/ 23
Harnoor Brar 11/ 14/ 22 n/ a 5/ 31/ 23
Daniel McCray 11/ 14/ 22 n/ a 5/ 31/ 23
Gurjot Singh 11/ 14/ 22 n/ a 5/ 31/ 23
Osen Ugbiyobo 11/ 14/ 22 n/ a 5/ 31/ 23
Julissa Aguilar 11/ 14/ 22 n/ a 5/ 31/ 23
Manpreet Bains 11/ 14/ 22 n/ a 5/ 31/ 23
Christopher Cadiente 11/ 14/ 22 n/ a 5/ 31/ 23
APPLICANTS FOR CONSIDERATION:
1. Angelina Michelucci
2. Christohpher Cadiente
3. Myli Bella Charlie Babagay
4. Zurina Folkes - Williams
5. Harnoor Brar
6. Gurjot Singh
7. Shubneet Kaur
8. Manpreet Kaur Bains
9. Tanya Singh
10. Osen Ugbiyobo
1342
p GC C nM
CUMMISSIONlCOM[ MITTEE APPLI `, ''
PAaKs n o RECR ArioN
Applying for: __ ''' ' dUi 4. A- h1; SSr oh
Snecial Requ[rements:
Youth Advisory Commrssion: Must be a Lethrop resident betwcen 13 to 18 years of age to serve on this commission.
SeniorAdvisary Conrmrssion: Must be a Lathrop resident 50 years of ge or over ta servc on this cornmission. 1'lanaing, Parks& Recreoteon Comniissions, and leasrrre C Oversighl Commitiee: Must be a Lathrop resideni to serve on this comrnissian.
PLEASE PRINT OR TYPE THE FOLLOWING INFORMATI4N:
r
Name: C I V 1(.- Q• LlC(.
Address: City: ' 1 a Zip: 3
Telephone ( hame) Telephone( wark)
Telephnne{ cell) Telephone ( ather)
ErnaiL• Resident of the City of Lathrop: , years
Do you have Transportation to attend the Commission meetings and Functions? Yes) NoO Background Information:
Are you related to a cunent City Employee? _ ,
If yes, give name and relationship
EmploymentNolunteer Information: 2,3 -- } 1 Q„ J
t o P
Or ani ation Date
t a 7`
01zS 2 4'.. t
Location Position( s)
Responsibilitiesfaceompl' hments: t/ S " 19 k a( L tt'' 0' Lc1 h4 a t.
Organization Date
Localian Positron( s}
Responsibilitieslaccamplishments:
1343
Community A tivides that you have been involved with{ feel free to attach ditional pages} Iu' Si` t V
j al S VU V'' D L 12/. St/' rvtt, l.,tr d.( .--- h, l/ 2 L("" f W Nanee ojOrganiaation Positio r.Responsibilities Uates
M -``-- r'".. h d th- Mh c
c a s 2 Zo ..... }-aw
Nante oJ rgani ulion Pvsi ion/ Responsibilities/ Accomplishmenls Atxles Special Awards or Recogaitions you have received: S h b -'` 5, c
t/ td 4 oI ` 9' Q f P` r t9- J P ` L2 fi Y' 3 SPeY¢ P
C Q' C'{„ trf tn o`rl<i'h f S£ t.c: c n P 1.,
R
Educational information:
h # ig t,1 a t 2r..
Eduratio ial Jnslitrrtion DegreelDiplorna Field Yeut
Edirrational/ nstitulion DegreefDfploma Field Year
Additiotlal IrifOl' m tlOn ( Pleuse p ovide any other iirformation whicli yoie j el ti onld be usefcrl to tlre Cily Coiutcil i t revie vingyoir appticativn.)
W o t h +{ t
Y t t` h S S ' ro 5
d I ! E' t. y v-c, r,` Pc G J L :
v e, Cvh ' f 1 uYe 4"0
4 S - a tti.e, r S T
Q, U t1 Q. h 0 d l Pu".
a r-1 r Nl o S o c, l ( e4-
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Pl sesig
ri and date or a licatinir a rd subn: it to t/ie O ice o tlte Ci Clerk at the address below.. 1' PP f.l . T h' tM 3
Si namrc Date
PBrendGuardi Sig»ature( Reqeiiredfor Youth Advisory Candidates anly) City Clerk
City of Lat rog
390 Towne Centre Drive
Lathrop, CA 9533Q
1344
COMMISSION/ CUMMITTEE APPLICATION
Applying for: _, u,, oL%Svr _ rnrniss%o2
Spectal Rcaufremcats:
7TKl' lPr 1a ..SOpf, d•M7¢+ tii
Yau1h Advisory Cammissron: Must be a Lpthrop resident bcnveen 1310 18 ycars afege to serve on this comrriission.
SeniorAdvisary Con+n issTon: Must be a Lathrop residcnt SO years of age or ovcr lo scrvc on ihis rornmission.
Plannleg,Parks dc RecrenNan Com nisslons, oad Ateusrrre C Overs ghJ Com niltre: Must bc s Lsthrop resident to servc on this cornmission.
PLEASE PRINT R TYPE THE FULLOWING INFORMATION:
aP 0 4 202
Name: e
RK
Address: City: t"Jql Zip: 5.,3 OU
Teiephone( home) Telephone( work)
Telephone( cel[) Telephone{ other)
Email: Resident of the City of Lathrop: / 6 years
Do you have Transportntion ta attend the Cornmission meetings and Functians? Yes NaO Background Inforrnation:
Are you related to a current Ciry Employee?
f yes, give namc and relationship •
EmploymeaWolunteer Ia[ormation:
s G- a o'// zz <_ r- s
Organrsa ron Date
y
firnrJ !/ a= _S o/ t'l.erri etLocation Pos111on( s)
Responsibilities/ accomplishments: G 1L O rrsu, s. SG+ lo/ dn ` iP/ v G/ e c ar , / 1 P, a,. 3/ t,P ,
L/. S h'ev / ub - / s o// a_
Orgadrzrrtton Dale
b lprt"
LocaNan Posit; on(s)
Responsibiliries/ accamptishmeats: YD/Grt/" PGl r 0 h Q. e c4Pievvra0'inQ rr, S r outi rr Cah ce^ rJa, r n,fs
v o'
1345
Cammunity Acrivitics that you have been involved with( fcel frcc to at ach additional pages) Du , Ac ur w C. ,SeGr iljl'/.z. - 05/.. i/ ao 3
Nonic ojOrganisati ia r " PosilioidRcsponsrbiliitcs Dafes Nunl ojOr, u: i_utiorr PaxrtronlRespernsfbilities/ Accnmptishruents Dutes Special Awards or Recognitians you bave received: / sc a.r /'3/.S 2.cr S . 5' uo'. c.' z ./ l'tcr t ..Qw-/ s G s .,1q.r^. a,/. ra. f3lr clc L " r' rr !'-o%( `i!r- cc rr p.fn. s rr
c// Pns 1/ s.
Educational Information;
n sd'a.le / rr,, Q, y irr. . h I f ir.` ro, G/ a o" 1
Educn in+all sritrrtfon Dcgrcr' Diplania Ffr/+dL. Yenr
p!. i7lp C.Zp.t'
r r. zC f L1! 5
Ediac; utionat irstitutron DegrttlDipJo rta iatr!— Ienr Additionat Intormation( Plense provtde tz y orher i jarmation vhfch youfeel uoutd bc usEf 110 the City Counci! in reviesi i agyou nppGcution.)
Z rry r rrrP LJ i t.t 4arl drI t ' e
4 iL r . A C1/ J.Sdr C..rra, ndss,r'on,.
A/ 1e s . 2act/' ftaF tt. t",•s/ P./- t/. L/'. rr. r 4 otr i. C: t2l d' _." la..rliro -.,' ti-. L'a rc r / r P { a _,_ i12 t rzL''.
Lvi7. -.++, re s
7 t Gr,+ r t/ t r llott- CG>t77muni u .
t r. Z` . rrc a culra_s- r - ilr- 5. iru. P cr
G o' G n, r _ 7" t..r!'/ cc rn,u. ' ie s
a
t
Pleus sig r ariddateyatr applictttian alyd suhn ld to tl e+Ojfice ojtlie City Ctprk at t/ae uddress below.. t'.',%--'- u -- G.3 / 6/:, 02.3
S ignaturc Qatt
Pa Guardian Si, t rc{ Reqltfredjor} autir AdvJsary CaaJdidates onty) City Clerk
Ci#y t f L. s throp
390 Towne Centre Drtve
Lathrog, CA 95330
1346
CUMMISSION/COMMITTEE APPLICATION
Applying for: , o,.„ v,,, C t'+m m. 5c+t' 1
Saccial Reauirements:
Youth Advisory Commission: Must be a Lathrop resident between 13 to 18 years of age to serve on this commission.
Seniur Advisory Comm sslon: Must be a Lathrop resident 50 years of agc or over to serve on this commission.
Planntng, Parks& Recreation Comrrrissions, and Measure C Oversight Committee: Must be a Lathrop resid this cammission_
PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION: APR O s ZO Name:
Address City: L,(., tit_,_____` Zip: `'' 33 a
Telephone( home) Telephone( work)
Telephone( cell} Telephone( other)
Email• Resident of the City of Lathrop: years
Da you have Transportation to attend the Commission meetings and Functians? Yes NoO Background Tnformation:
Are you related to a current Ciry Employee? r' C
If yes, give. name and relationship
EmploymenWolunteer Information:
Vbc le{. t G- n. c rr. F+ ( SS SI,.#. i c r
c{ 2acs o tti
Organiaation D e
a-- v
VKS ,.
t-q ' t 1 n+r' C e e 1+ c r5
Location Position( s)
Responsibilitieslaccomplishments: (, i , d, 1 e' n fcs ,.,,,- s.
Organizatian Date
Localinn Pasition( s)
Responsibilitiesfaccomplishments:
1347
Community Activities that you have been involved with( feel free to attach additional pages) MnS P 1 Vc^ ti ree' Mn C, nc cZ.a
Nanre ofOrganizatia2 ositian/ Responsib lrties Dales
M_r sdcu sci t o C otDe r1G 20
Name aJOrgani_ a io i Posi ion/ ResponsibrlitieslAccomplishments Dutes Special Awards or Recognitions you have received: „ o,. rec eu] r rv'N« Lalps mr F r. L_ 1r... l, s. . s. xi1C r. , 1+a. e.f rbi 4.,..
Educational Informatian:
t
k
c e aEdiccationa! Ins i ution DegreeJDipJonra Fi Year
Edurationa! Institi iwi Degree/ Diplana Field Year
Additi0t a1 I[tformatioq( Pleuse provide any other informution tivhich you jeel x>ould he: uefti! ro tlre Ci y Co tncil in revie ving yoii applicrrtron.)
1 , t -T- o- r br 1., u.{'P ra Vt Gr^ i'{-, n n c T r.c eN2 N 1 iv _ tYVI— Q O .' 1 f YNM'L'1 . It
Please sig and date you upplication aiid subntit to the Of ce ofthe City Cterk at the address 6e% w.. r 3- v -
Signatu' e U!' e
J
r' C , r"r
ParendGuardian Signature{ Reqi+ i dfor Youth visory Candidates only) City Clerk
City of Lathrop
390 Towne Centre Drive
Lathrop, CA 95330
1348
d MMISIQ taMMITTEE APPLICATION
A' R 12023
PA' A"C
6urh a. v s d,r co r; s.s o c
Sneciul Reuuirements:
Ynrrtli Advisary Cmm: issinn: Must be a Lathrop resident bet vicen 13 to 18 years of age to serve on diis commission.
Senivr Adi=isar,y Commission: Must be a Lathrop resident SO years of age ar over to sen e on this cotnmission.
Alanning, 7' arks& Recreatinn Cn1rr» issiuns, nnd Measure C pversighr Cammitiee: Must be a Lathrop resident to serve on d is commission.
PLEASE PRINT t) R TYPE TNE FOLLQti' ING INFQRMATIUN:
Name: J 1 YI.t.Z.. O t.c1 i 1 { iGX.
Address: City: _ ... r-t,"Ir t"' ' Zip; g 3
Telephaae ( home) Telepl one{ tivork)
Telephone( cell} Telephonc{ other)
EmaiL• esident oFthe City of Lathrop:_ J years
Do yau have Transportation tc attend the Cornrnission meetings and Functions? Yes [ Y1 No L7 Back round Information:
Are you related to a current Ciry Emplr yee?
f yes, give name and relationship jj
Employmentll' olunteer Ir formatian:
Z2 /' 3
Organi ation L} ute
t_._ t t , i 6 t C LL{ '-('
Locarion f' osition( s)
Responsibilitiesfaccomplishments: R2 Pp n j a Y' C o lf l'fjY 1+ 1d C , c,uY_t,. i g T L Y t C Gc d- v'i` c.us 6w- r
r
D F a. h,t o i" 2 12
3rgnnizutrvn Dute
L- t- h,-ra 1° a..S 1 i '
Locatinn Pnsition(.sJ
Responsibilitieslaccomplishments; 2S F' ang, a ,,. o r l C' i 9 yh p (, vy , tV} /'t, "!,,? C 1' r-- t [7... l'. t— F.Xx' cxl+n.2 s.'.,r l f i C U , tG' Y!'(, P.." S 1349
Ctimmunity Activities that you have been involved with( feel free to attach additional pages) Ca. s r r.,d Pa,9 n - Cati'-,- 2.2.../ l5
Name af rgn rr_ation Pasitiorr Respansibilities Dates
t. 3a...ha.. f. ysn e tdfi ,' 1 Bi bt Y 3e." 20/ g f2a 2-Q NameofClrgani atiatt Aosition/ RespvnsiGiJities: tec on:plrsh» rentc Dates Special Awards ar Recognitions yau have received: t 1'' C' t.( Educational Information;
ft - s. s Nl z a.
Edurc ttonallnstitutian Degree=l7iplomu Field Year
r'v j' high. ot. 1 A a `.-
Ec ucalioncrllnstitutron Degree' Lli tanra Field ear
Additional Infflrmation{ PleAse provide anv other i rjormation vlueh yo: feed- ould 6e use rllo the Citv Council in revie i ing yair u} plication.)
J 5 ' t G. VS t'i'C fic G"` l. tCd ' tP `' A'' W t- 1ti'-1( Q Y' a.x#- c. f't.d o v i t.. s k'` .' V i' - •
Please sigii und rtate yoir upplication aud sribn:it ro the Offrce nft/ee City Cterk at tl e address hetv v.. i 2.ii' Q1.'-', 1---- 1.-
5 gnature Date
ParendGuardian 5ignature( Reyerired for Youth Advisory Cartdidates only} City C1erk
CiEy of Lathrap
390 Towne Centre Drive
Lathrop, CA 9533U
1350
4 °`
CONIM SSION/ Cf MMITTEE APPLICATIUl
4! z
0 Applyillg for: I' ! I1
tJ w
Sptcial Reqniremeata: w
Yautb Advisory Commissiar: Must be a E. athrop rcsident bttweet 13 to t B years of age to serve an this c mmis o . ' z Senlor Ads sory Coni uissJan: Must be a Lathrop residrnt 50 years af gc or over to se rvc on this carnmission. t/3 Plan» tng, Parks< k Recnmion Come issions, and Mtesrrrr C Overslght CoruurFuee: Must be a 1, atiuop residr e serve on Y this commission.
L== r_.""_, n`
t.
I,FASE PRINT OR TYPE THE FOLLOWENG INFORMATION:
Name: —
Address• City:,--- Zip: U
Telephone( home Telephone{ work)
Telep ghon( other)
Eraail Resident of the City ofLathrop: years
E7 o
yau have Transportatian to atteud the Cornmissian meetings and Functians? Yes No Bacic rauad Informatian:
Are you related to a current City Employee?
f yes, give name and relationship
EmploymentNalunteer Iuformation:
v
r r'zaremr oare
Localion position( s)
Respo ibiliti accomp ishmants: L 5 O
4 r
C z ,____ r
ILI 2n23
Qrganizatian D re
I
Ltrtatian Positian( s}
Respon ' bilities/accomplis rne ts: S
1351
Community Activities that you have been involved with{ feeS free to attach additinnal pages JVame of Organizatrarr PositinnlRespo rsibilities Dates Name ojOrganf: al[ort PasitionlRespons/ bilitieslRcromplishmeRts Dates elal Awards or Recognitiona yon have received; 4 s,
a
5 l r , ll. 5,! . 1: f
y
Educational Infflrm tioa:
a22
irca# anal lnsfitution flegreelDiploma etd Yeur
Eduralional instftuliaR DegreelDiplama Field Year
Additioi t i Info['m8tittR{ Please provide nny ather i jormution whFch youjee! would b usejul to 1he Cltv Counci! in review yo r app icution.)
Ptease sigtr a rd date yau a,pplicatios and sub» it to t/re O ce ofthe City Clerk at the ttddress b low.. 40`` ,' Zlf 202'
signawrc t?ats
st" t3h k
ParendGuardten Signature( Reqrrtred far Youtly ddvlsary Candfdates only} City Clerk
City of Lathrap
390 Towne Ceatre Dr ve
Lathrap, CA 95330
1352
1 ``y..
CCIMMISSION/ COI iNii'TT'EE AFPLICATION
o
ApPlying for: tr, a
a
Sncdal Rcauircments: j
c.
o w
Yarrth Adyisary Comn lsslon; Must be a Lathrop residcnt bctween 13 to 18 years ofagc to servc on this ca n.
Senlor Advisory eommfssiad: Must ba a Lathrc resident 50 years of a e ar over to strve att this commiss Plaanitrg, Parks. fi Recnatiod Co issiom, and Measare C Oversight Commtdre: Must be a Latlu op res this commission, o servc on Y
C
OG
PLEASE PRINT 4R TYPE THEFQLLQWING TN t, RM TION.
Namo•
Address: City:._,,, i
j;.l.l Z p.
Telephone( hc mc) Telephc ne( wark)
Tetephone( ceIl) Tele hone{ other}
Email. esident af the City of L,athrop: _ years
Do you have Transportatioa to attend the Commission meetings and Functions? Yes No Background Informatian:
Are you related to a cuirent City Employee?
Ifyes, givc aame and relatianship
EmploymentNolanteer Infarmatioa:
c7 - } c" 2 t t i1 -
Organ attan tp
T l
i
1 1 ', J`- tY' x'- V l'3`; rl'1-'.,.. 2., C`'
LocQhan Posltion( s)
Responsibilities/ accomplishments:
C) gantaation
Locotian Pasitian( s)
Rtsponsibilitieslaccomplishrnents:
1353
Y,,
Cammunity AcNvttiea that yau have been involved with{ feeI& ee to attach additional pages) Narna ofOrgareization Posittan/ Responsi6il+ties Dates
Nume aJQrgnnisalion PositfottlResponsibf ftfes/ Accamplishu en s Dates Spectal Awards or Recugnitions you have received:
Educational Iuformsttion;
Edttcalional lnstihuian DegreelDiploma Field Year
Edercateonallnstftutian DegreeJl) iptanea Field Year
ABditiOnal ItilormBtioD( Please provide any vther irrjormrrtion wl7tch yoirfecft fi autd be crseful to the Ci1y Council in revie vr'ng you appticai on.)
PJea re srgn artd dale you applicatinn at:d stthmit to the ce aJthe Clty C7ark at the address below..
Sign turs Datc
e n
Parcnt/ Guardian i twtturc equlredfar Yat th Advisory Candidutrx only} City Clerk
Clty of Lathrop
390 Tuwne Ceutre Drive
Lathrop, CA 95330
1354
4 COAtMISSIONlCOMMITTEE APPLICATION
a
Applying for: ou' t vi5or" CAY"
Soeci l Reauirements: C
w
Yoarlr Advisary CoAuarissian. Must bc a Lathrop resident between ! 3 W t$ yeaes oE' age to serve an tbis camm on. '.~ c Seninr fdvisor F Ca n,ission: Must be a Lathrap resident 50 yeats af age or aver to serve on this cammission a 4 Flanxlr g, Parks,& Recreation Cnmmissio ts, attd Measttre C Oversight Cu» tt tJttee; Must be a Cathrop resi+c j to Serti•e vn X this cornmission,
C Q PLEASE PRINT QR TYPE Tli FQLLOWING IN' ORMATIUN:
Name: Shubneet Kaur
Aaa s: tathrap CA Z,p;
9533
Telephone( honne} Telephvne{ wark
Telephane( cel!), 11, 1, Telephone{ other 1111 1.
Ernail Resident c fthe City af Lathrop: ye r
Do you have Transportation to attend the Commission meetings and Functions? Yes No Backgrownd Int'c rmation:
Are you celated to a current City Employee? o
If yes, give name and relationship
EmploymentlValunteer Information:
Qrgcarizatrvn Date
Locatian Positio( s
Responsibilitieslaecamplyshrnents:
Organiratrort Date
Locatian Posi rort( s)
Respc nsibilitieslaccomplishments:
1355
Community Activities that you have been involvec3 with{ feel free to attach additional pages) h'anze ojOrgantzation PositianlRespor ssibiliti s Da[ es Name of Organlzatlon PosttionlRespansibilitieslAcramplishments Dares Special Awards or Recogn tions you have received: M s, Cerifciates, Honor Rolls, Perfect Atfendance
Educatic na[ Infarm$ tian;
Joseph Widmer Elementary 2 12
Edurationrrl lnstitution DegreelDiploma Fietd Yeur
E. athrop High Schoai 2022
Educutrarrallnstrtuttvn Degreef.Uiptoma Freld Year
Additiansl Informatian (Pleuse pro jide any ather inforn:atrvn vhich youfeel would be useful to the City Council r revietving} ou applicarran, J
Baseti off of my experience whilst working with others I believe I cou d play an important role as a YAC member and make use of my integrity a nd responsibility to ftafill my future educational an saciai goais. Through leadership I wauid be more then happy to advertise, par#icpate, and attend all events when neccasry.
Please sign and date you apptication and submit ta the Office ofthe City C7erk at the address below., 4/ 11I20
Signatu Date
ParenVGuardian S'sgnariuc{ Required J'or Yauth Advisvey Candidates only} City Clerk
City of Latlirap
390 Towne Centre Drive
Lathrap, CA 9533Q
1356
C4MMISSION/ COMMITTEE APPLICATION
Applying for: 0} h Advi ot'y om,rn s5 or
Socciul Rcquircments:
Youth Advisary Comnrission: Must be a Lathrop resident between 13 ta 18 years of age to serve on this commission.
SeniorAdvisory Conrnrission: Must be a Lathrop resident 50 years of age or aver to serve on this cammissian.
Planning, Parks& Recreatinn Comniessions, and Measure C Oversight Conrnrittee: Must be a Lathrop resident to serve on this commission.
PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION.
a 3 oz
Name: __1 lQrnQt` 2e} av ti1n i'!"W' !' ti
a
Address: Cih'_ roP . _ Zip: q r'J33 0
Telephane ( home Telephone{ work}
Telephone{ cell} Telephone( other)
Email: Resident of the Ciry of Lathrop: ti rJ years
Do you have Transportation to attend the Commissian meetings and Functions? Yes NaO Background Information:
Are you related to a current Ciry Employee? n
If yes, give name and relationship
EmploymenWalunteer Information:
Cs ce.eri Gl b
a J HS ;. 12122 -- P' e seh
Organi: ation Dale
4 Yrro gh S nvc 1 Yv, mbe'
Location Position( s)
Responsibilities accacnplishments: Col 2G C'e, cx ne Gy 1ec '' a s cxs' n G nio YtSGhoo1 carr p t5.
laS "S nkt- uG Clvb v ,'( "_ pr sc''.
Urganization Da1e
cr k
n t"aP M Sc,tr, oal memhCY
Lacatinn Pasrtian( s)
ResponsibiliEie accomplishments: - t d j UG1£ d Sa wiGhQ r q, wrp} e
YYto ivG- t iq np ' n' t5Sc l
t,S a'`R kor n t SS .
1357
Community Activities that you have been involved with{ feel free to attach additional pages) ov r, A t, Sa cy Co+ m SSivn ViGe Ghair Y
II /{ 19 2 — ' esent
Nan c of Orbanizatiar Positiorv' Rcsponsibilitie. s T Do1es A 48 2' 1
l .,. _ ( Lf-I / 2,1
rl ennic 1 eGa' hion rn2 b. r
1 Nume ojOrgani uriat ositrqn/ Responsibililies Accomplishmenls Dutes Special Awards or Recognitions you have received: ac k- n ( o} y. C -- ( a/ 9 ,}, HS Sfivc en o k` n MoY, kh qwarcl }.. 2tt i Bla k '"L" Mocsc.a1 T wc rc, S 1. 1SQ diS ric YY c tk1' 1 GiwAfi , VQ1. cs 1G} oric n ' or OSSc QI Educational Information:
La ncoQ i9i^ Sc. nool N 1
N A 2oZ S
Fdrrcatiaral lnstittdion DegreefDiplvnra Fie/ d Year
N , q
Edriratrana! Inscitulion DegreelDiplonta Field ear
Additional Information( Please pr•ovide any other informatrafi tivlricl7 yocr fee! x auld be ttsef af to the City Courrcil in reviewing you application.)
am Cuc'Y nkl h8 ViGC {. f1Gt1r f 'h ou h Adv;So+r r ComrriiStion q} tkhd' b?, t ve_ m+ E'+ x} u t+.+n Ql tnr'ter 1.. - h Co t c.i) R
ur. l 1 o e Gu n' t; nvp. ' o ' he Q• + ack a i-# . } ` 1 A C Some, e. c.n S - n a' rU e vO vrlh{' t or w. t' 3 Ont3h' S Us j' n JQvt} A orz ar5 wi , uv v_ ar a- hri5 ww.S a ra.o 2 1 bv tije.iru : rti Gh q,. a ecka+r Ska ir,. S a waC a, c. t-k o - fhZ - rn . s bui 1} - 3 e YAG aa}. ut n C t,r- f lo1Un. c ak e Snwc.' bar a lZe Csenu-w++• GcX• t s
Csr++ d Ca e • 1 o e } o be Gt ack a F - nc c.a„ Y,,,-} e wga r, and Gvnt nv E: - t . v Q, IQ t-ht co.+nm.m y .
Ptease sigrr a d date yau applicalion u rd sr bnrii to the Office oftlre City Clerk at the address belaw.. g, + ta.t.' t p W 101 Za 23
Signaturc Datc
L - f 1",_. 3
Pa Guardian Signatur ( Required jor Y'outJr Advisory Calydidates o rlv) City Clerk
City of Lathrop
390 Towne Centre Drive
Lathra, CA 95334
1358
CO1;i1ViISSrON/ QNIMITTEE ACPLICATIO
p ying for: Yo l i So m L rL
Si rciai itcguirrmrnts:
t urh t(rt i or C i+nxrisxi rr hlust bc a Lathrvp res cfcnr bctx ccn 13 to t K yean uf agc to scrvc on this cammissiun 5rniar. ldi isnr• Cun r ssir n: liuss bc Lati rop rrs lcnt 54 ycars of agc or o tt 1b scrrc un thi9 Cortv» is ion. i'lannin, Parkc& Ite c rrorinn' rrnrmisri rns, prid, 9lc rs rre G'() trxi h Cnrnr» Fnet: 11ust tz a t. atfirop residrn to s i i cui. ui icsinn.
r. A. PRiNT nR TYPC TNE rdLC. O VING Iy C? ftt lATIn V: A' 3
C' Y CL RK
I 7cnc:
Adc ress: CitY:., 1 Q.. A_. P.,, 3____..
cicplrc}nc( homc Tclephanc{ work}
T' cicplyunc{ ccilj Tclephone( othcr)
Emai] csis eni of 3e City flE' Lothrc: '.. ycars
l u yar lia• c Tr nspanation to aktcnd tlzc Con mission wncc in; s and FunziionsT Yes Nu I3nci:; rauud Inl'ormution.
lt c yoti rclatcci io a curret i City Employcc7 Q
If yc. ivc name anci rclationship .. Yl, 71 —
mpla}' ment/ 1' nlnnteer informasion;
K 1 Y YS S C` iC 50 - - - r var 2- rz e t
Ur ant: rtttp poSe
e c ev nfi - an t f- 1e' N+ ln ca n s pCes c ev1 c nd C r i r Lcrruur rr arirtnn( s)
lZes t nsibilitics/ accUm lishmet ts: ` s''— i`
ti ' l'1`} Y' u(1L 1.. L P {' l,St' f''
01` V1J[ C' S £ 4`1t5 t r ih
5ia' aA Fi NtSSuy' gA aC S tt Sic+rS ncZTi* tS rva . 0 r" 1u}, S u 4 c i r n a nu . oz3- msr; urt: ulit n f3r dC
at ; o0 a y . nt ve 1 n Ccx r nr t r
L, ttirerr f'osiiFnrr(.r,
7 ltcsponsibilititsJaccorilplishmcnts. —( P.If C11 1''S tT i./ t l. SE' Yif ar ecl.. a t 1 tn sac am tiu o advacat a sobucco, Y c, r, lec a o Ctcco was e garK cte n v av tru' k in 1359
Crtn iit nit, tictiritiex ttia r
u harc bcen iuvolvc 3 iah( fccl frcc to: t aclz adaitioiial cs
1.: S Y c S ci ery 1Pade s`hr' crerxc r 2- 1 b.
i: mc nf Ur n+. rrtinrt 1' o.ciAc ntltts rnnsth tftir. t — r
4tG+ ic» t,} SZt,4S t 1 i1tG'ii, d' LrS uttu srs f r rntmbcrS 1ll I1 1 K. 1 C 1 1S' o- YO.. 2 S- 3l I
A't, mr rJ' C) r; unt_utivn t'otiriurrtftr, cpon.tit ititicstrtccarnpli.rhmcnrs l3r: rrs waranr p;, i xtsrt ft qtzhK! i0St 7lL tRQit9 to dFiVlttl t c in5r ; 9 1cta tipeciai ttrds ar itcco n tlnns you ( arc retcii ed:„ I{.+. 0 ' 2 —P' 7"` Y 1C c 1 1 Gt" I
Eclue t€ onal [ nsorm tion:
1 i
F"rh utiunot/ ntt iuttun Ilrgrcrll.tr'jllantn f+c1 1 eur E+luc rr rrrrr! l strturiun tlrgrrr!! J'i trrrrr J rrld aur ldditlon: rt Infarma ion( t'ls cesc prc» t lct r/ ryt ntlrc r t!furr+rutlon xl iclt, i'rn fee! ss•vtrtrl Gc usefrrt tn the.' rir Co1m`( rn r' le+ m,*}` r tr u}xJ flc' uliu t.)
iI VC t 1tt C nu r. fiU fl' or. tr ft rX atton,
Plertse si t ant/ dult, uu rPnlicatiu urrrt, crrhrilit t ttre D ce vf!! C Cit Ctrrk at thr urldress bcrtm.. 1123
S gna urc Datc
r
ParenVGuartl an 5, oturc( Rr uir
otith rtc/ rrcr r,• Cundrrlcrts. t orrl)
C3t}° Clerk
Cit}' nf Lathrap
34p Tn ne Centrc pr ti•r
Lathr p, CA 95330
1360
CUMMISSIUNICOn IMITTEE APPLICATION
Applying for: y- n c vi' Y_v,', prnm i Sti c n
Saeciat Rcauircmcnts:
Youih AdvFsary Cammissian: Must be a Lathrop resident between 13# 0 18 years of age to scrve on this commission.
ScniorAdvisory Con issinn: Must be u Lathrop resident 50 years ofage or over to serve on thrs commission.
Planntag, Parks& Recrcatfon Commisstvns, and Measerre C Overslght Cunimltl e: Must be a Lethrop resident to scrvc on this commission. t r
PLEASE PRINT OR TYPE THE FOLLOWING iNFURMATION:
V
M Y 03 2023
Name: IC K
Address• City: Zip: g,
Tclephane( home} Telephone{ work)
Tetephone( cetl) Telephone( other)
Email: Residettt ofthe City of Lathrop:_ years
Do you have Transporiation to attend the Commission meetings and Functions? Yes No Backgrouad Ioformat an:
Are you related to a current City Employee?
If yes, give name and reiationship
EmploymentNolunteer Information:
s 2_'` 7' c t h g c P 1' V1it n
QrganLvtion Date
tC l.t, b` rop 1fi aL, ViD` t 1 1 r'
Loca lon Position( s)
Responsibilities/ accomplishments: YY t'(1 S C?n OU f +ri c c'11rn e 1 " ' v' d '
J hroa ' ah`- r1s ' Y, e. ba m 2022- 2oz3
Orgnnizativn
i
Date
l. inrQ N o, C r' etn C! o
L cation
T—Pasition(s)
Responsibilitieslaccornplishments: 20ZZ - Z o" L3 Cvac1` 3 t., rcl . YYi Y1( m _ Q
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Cammunity Activities that you have been involved with( feel free to attach additional pages) CX v g t?i l YT1 a Vi S Ylic 6 vJ+' n Y ktv PS
Nomc ofOrgani: ation Posireon/ Resporesibilitrrs 13ates flY1V S J i ll S"PY
w aY 85 2r ' x.inW
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11jv ne ofOrgmti: alion asitivn/ Responsibfltilesl 4cromplishments Dut s Special Awards ar Recognitions you have received:
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1.1J K' 1
Educstiana! InformaHon:
Bdu atfona!! ns rrtlon L7egreclDiplama Ffeld Year
EtIIfCQIlOAl1/ I11Sl IltllpR DegreelDiplvma Fietd Year
Additionat[ nformution( P1edsC pravtde any other rrformation ivlrichyoujeel rould be usefiil! o tlie Ciry Cou ci! in revie ring votr uppJiration.)
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L, d t ys
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P/ease sign and date you a
plicatio i and s bmit to tlie O ce o,/'the City Clerk a11he address Lelow..
MstircY' 231 t12
s
Pare uard'tan Signaturc( Requiredfor You h Advisory CandJdures only) City Ci rlc
City of Lathrop
390 Towne Centre Drive
Lathrop, CA 95330
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