RECEIVED
CITY CLERKS. OFFICE
CITY OF RICHMOND
2021 0C 15 PM 3: 07 BOARD OR COMMISSION APPLICATION FORM DATE: 10/14/2021
Check one: New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION: Zhoushan Sister City Commission NAME: Ed Medina
HOME ADDRESS:
ZIP CODE: 94591 HOME PHONE: WORK PHONE:
OCCUPATION: Deputy Chief of Police (Ret.)
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: N/A PLACE OF EMPLOYMENT: City of Richmond, Police Department (Retired) REASONS FOR INTEREST IN APPOINTMENT:
To assist in furthering the relations between The City of Richmond and it's Sister Cities programs.
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
Served 27 years with City of Richmond Police Department. Now retired.
EDUCATION:
United States Marine Corps (5 1/2 years), 2 years college REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address)
1. Stanley Li, Current President Zhoushan Committee, e
2. Trina Jackson, City of Richmond, ise jackasn@
3. Louie Tirona, Assistant Chief of Police, Richmond PD,
4. Lucy Zhou, City of Richmond Port Department, her
5. Nat Bates, City of Richmond Councilman,
Tolthe best of my knowledge the information provided is true and correct:
Oct. 14, 2021
Signature Date
Deliver or Mail to: City Clerk Or Email to: [email protected] 450 Civic Center Piaza
Richmond, CA 94804
For Office Use Only: New Appointment: Reappointment: 01st 02 03rd