2 Revised June 10, 2025
BOARD OR COMMISSION INFORMATION
Board or Commission applying for*:
1st Choice
2nd Choice
3rd Choice
*If applying for the Accessibility Appeals Board, please indicate which position you are applying for:
Physically Challenged Member Member 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
Do you currently serve on a City Board or Commission? Yes No A. If yes, please list:
Have you previously served on a City Board or Commission? Yes No A. If yes, please list:
Do you have any immediate family members serving on the city council or employed with the City of Moreno Valley? Yes No
Can you attend evening meetings (6:00 pm – 9:00 pm) at least once or twice a month? Yes No
Are there days you cannot attend evening meetings? Yes No A. If yes, please list:
List any education, training, or special skills you have which may be relevant or of particular benefit to this Board and/or Commission:
Library Commission
Planning Commission
Senior Citizens Advisory Commission
Library Commission
Saturdays and Sundays
B.A. in Philosophy, Master of Library and Information Science, 27 years of law library management experience; served as Recording Secretary for the County Board of Law Library Trustees, served as President of Southern California Association of Law Libraries, President of Asian American Law Librarians Caucus of the American Association of Law Libraries (AALL), and served on the Council of California County Law Librarians Legislative Advocacy Committee.
Library Commission
3 Revised June 10, 2025
ACKNOWLEDGEMENT
I acknowledge that I was provided with the attached copy of Legislative Policy #1.10 (City Council Advisory Boards and Commissions) and offered an opportunity to ask questions regarding any of its provisions prior to submitting this application.
CERTIFICATION
I certify that all statements in this application are true and complete to the best of my knowledge. I understand that any false statements of material fact will subject me to disqualification or dismissal if appointed.
Print Name/Signature Date
All Applications shall be submitted to the City Clerk’s office at Moreno Valley City Hall – located at 14177 Frederick St., Moreno Valley, CA 92553 – during regular office hours (7:30 a.m. to 5:30 p.m., Monday through Thursday, and 7:30 a.m. to 4:30 p.m. Friday). Alternatively, applications may be submitted by mail or electronically v ia the City Clerk’s email [email protected].
Background Check Authorization
As part of the application process for service on a City Advisory Board, a criminal background check will be conducted through the California Department of Justice. Please be advised that you will not be provided with a copy of the criminal background information received from the Department of Justice unless you are deemed ineligible due to a disqualifying criminal conviction.
Attachment: Legislative Policy #1.10 – City Council Advisory Boards and Commissions /
July 8, 2025