MORENO VALLEY CLERK
325 JUL 31 PM12:25
OR MORENO
City of Moreno Valley
City Council Advisory
Boards and Commissions
Membership Application Form
Name: arr
Home Address:
Marno Valley, CE 9555
City Council District: -
How long have you resided in Moreno Valley? — yeang
ELIGIBILITY
Are you at least 18 years of age? Yes E No D
Are you a registered voter of the City of Moreno Valley? Yes • No O Do you authorize the City to process a criminal background check? Yes No C
EMPLOYMENT
VOLUNTEER SERVICE
Name of Organization:
Purpose:
Title:
Length of Time:
Revised June 10, 2025
BOARD OR COMMISSION INFORMATION
Board or Commission applying for*:
Planning Commission
1st Choice
2nd Choice E mergins Leaders Council
3rd Choice (t littes 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 B 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 B
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 W 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:
Chapoman University - Master's of Science in Real Estate:
University of La Verne - Dachelor's of Science in Business Administration Real Estate License
Wall Street Prep , ULI - Real Estate Financial Maleling Certificates 2 Revised June 10, 2025
ACKNOWLEDGEMENT
Board and Commit sions) and ofered an opportunid to a or testions reparing any of is prun prior ty 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. 7/29/2025
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