OR MOREN MORENO VALLEY CLERK
CITY 325 JUL 29 AM10:39
City of Moreno Valley
City Council Advisory
DECEMBER 1. FAM Boards and Commissions
Membership Application Form
Name: Dennise Jimenez
Home Address: Moreno Valley, Ca. 92555
City Council District: District 2
20 years in December 2025
How long have you resided in Moreno Valley? -
ELIGIBILITY
Are you at least 18 years of age? Yes D No O
Are you a registered voter of the City of Moreno Valley? Yes E/No D Do you authorize the City to process a criminal background check? Yes No O
EMPLOYMENT
VOLUNTEER SERVICE
Name of Organization: Citizens Bond Committee - MVUSD
Purpose: Bond decisions
Title: Vice-Chair
Length of Time: 3 years
1 Revised June 10, 2025
BOARD OR COMMISSION INFORMATION
Board or Commission applying for*:
1st Choice _ Planning Commission
2nd Choice Utilities Commission
3rd Choice Senior Citizens' Commission
*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 ENo D A. If yes, please list:_Environmental Committee
Do you have any immediate family members serving on the city council or employed with the City of Moreno Valley? Yes No D
Can you attend evening meetings (6:00 pm - 9:00 pm) at least once or twice a month? Yes No D Are there days you cannot attend evening meetings? Yes • No E 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:
I bring over a decade of experience in healthcare management, community advocacy and operational strategy with specific expertise in Medicare and Medicaid programs. My involvement in employee resource groups and career development initiatives for Latino professionals reflects my commitment to inclusive leadership and workforce development. I'm particularly passionate about responsible development that reflects the needs of all community members.
2 Revised June 10, 2025
ACKNOWLEDGEMENT
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 July 28th, 2025
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 via 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 3 Revised June 10, 2025