HORENO VALLEY CLERK
125 SEP 17 PN2:05
City of Moreno Valley
ORCEMBER S.192 Boards and Commissions
Membership Application Form MORONER NOT ERK
Name: Nikita Wilsan 125 SEP 17
P·2:04
Home Address:
loreno Valley CA 92551 Distrid y
How long have you resided in Moreno Valley? 11 Vears
Board or Commission applying for*: 1s* Choice ParkS, Community Service and trails G.P.
2° Choice Emergine leaders Concit Senior citizens
*If applying for the Accessibility Appeals Board, please indicate which position you are applying for:
• Physically Challenged Person • Person Experienced in Construction • Public Member *If applying for the Utilities Commission, please indicate which position you are applying for:
X Public Member • Customer of Moreno Valley Utility • Business Customer of Moreno Valley Utility Hey to you wish to serve on this Board and or Commission? Proud Moral native since my middle school years. I am passionate about our city. My desire is that we collaborate to make our community a more beautiful, safe place to reside. and call home.
List any education, training, or special skills, you have which may be relevant or of particular benefit to this Board and/or Commission:
Ihroughout My Career, I have succefully managed my nonprofit organization dedicated to feeding and supporting our Communit drawing from my expertise as ordained pastor, Certified life Coach E:t. e Explain briefly your understanding of what this Board and/or Commission does, including its powers and Overseeing for the betterment of communit
fulfilling a Visian for the people while not pursuing
our own private intrerests. humble power.
What do you hope to accomplish by your participation
Dan am making criter and familes , Love, understanding, sate, heard and scen:
List any 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, and dates served:
Im a Caregiver for over Mineteen Years, I have Served
in Various outreach organized outreaches. I also have
a nonprofit that has been serving in Moreno Valley for over five cars.
What other areas of interest do you have in our City government? open.
Would you be available for meetings during the day If or evening? Ill Both.
Attendance of at least one (1) meeting is required prior to the appointment.
Date(s) of the meeting(s) attended: H 2602025 € Sup 14th 2025 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 California State Summary Criminal History and in records of the California 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 and that any false statements of material fact will subject me to ed. I release the City of Moreno Valley from any liability for the Sep 16,2075
/Date
Please Note: Applications will be kept on file for potential future vacancies for one year after the application submittal date. Applications are accepted year-round. All applications are public record; personal information may be redacted to protect applicants' privacy.
Revised June 13, 2018