24 APR 16 AM 8: 21
City of Moreno Valley
Boards and Commissions
Membership Application Form
Gabriela Mendez ulna
Name:
Home Address: Marene Valley DisTRIcT 3
92553
How long have you resided in Moreno Valley? One tear i la Six Months
CONFIDENTIAL INFORMATION
Home Phone No. Driver's License No.:
Work Phone No.: Email Address:
7007/301999
Cell Phone No.: Date of Birth:
Employer Name: THHS Position: Caregiver
Address: ZIZS 925 Day St. 3-Posii Meren& Valley, CA.
Board or Commission applying for: 10 Choice Enviranmental & Historical Presenuation Board 2nd Choice
*If applying for the Accessibility Appeals Board, please indicate which position you are applying for.
L Physically Challenged Person Person Experienced in Construction Public Member *If applying for the Utilities Commission, please indicate which position you are applying for.
Public Member Customer of Moreno Valley Utility Business Customer of Moreno Valley Utility *If applying for the MV Citizens Public Safety Committee, please indicate which position you are applying for: • Non-Profit • Business
Why do you wish to serve on this Board and/or Commission? a returina member it accepted, I would like to continu
to serve the ilty and engage with community on importan! matters Pertainine environment and historical preservation.
List any education, training, or special skills, you have which may be relevant or of particular benefit to this Board and/or Commission:
enrolled as a student at the University
of Califarnia I am currenty Riverside. I also am trained an envirenmenta issues such as land us
antain bit your undersaning or hate an and omen des us ta aba lity. main environmental i Historical Proervation Beard tackles concerns arand hazardos material, protection of landmarks and neighborhoods, we hold the power to serve as an advisory healthy communities.
Listany employment, volunteer work, or membership in a service/community organization that you have served on, or are now a member of. Please provide the name(s) of the agency (ies), contact person, I formally served as an Organizing Condinator at the Center Roths office in 2017.
What other areas of interest do you have in our City goverment? in all areas of Movals City government I am interested
and would be henored to continue to serve this
great city.
Would you be available for meetings during the day l or evening? DA Attendance of at least one (1) meeting is required prior to appointment.
Date(s) of the meeting(s) attended: 05/07/2024
Pursuant to Resolution 2016-42 all board and commission members must be registered voters of the City of Moreno Valley.
I authorize the City of Moreno Valley to obtain and review, on a confidential basis, such information regarding me as may be contained in the Califomia State Summary Criminal History and in records of the Califomia Department of Motor Vehicles. Yes • No • (The application shall not be considered if the NO box is checked.)
I hereby agree to attend all board or commission meetings, unless excused, and understand that I may be removed for lack of attendance, pursuant to Municipal Code, Subsection 2.06.010(C) which states, *If a member is absent without advance permission of the board or commission or of the appointing authority, from three consecutive regular meetings or from 25% of the duly scheduled meetings of the board or commission within any fiscal year, the membership shall thereupon become vacant and shall be filled as any other vacancy.
CERTIFICATE OF APPLICANT: I certify that all statements in this application are true and complete to he best of my knowledge. I understand that any false statements of material fact will subject me t lisqualification or dismissal if appointed. I release the City of Moreno Valley from any liability for th use of the aforesaid information.
04/12/2024
Signatire Date
Yease Note: Applications will be kept on file for potential future vacancies for one year after the applicatior se redacted to protect applicant prited year-round. All plications are public record; personal information mas Revised una 15, 2020