RECEIVEO
CITY CLERKS OFFICE
CITY OF RICHMOND
3022 APR @ PM 1: 22
Bles
BOARD OR COMMISSION APPLICATION FORM
DATE 03/03/2022
Checkone. New Appointment I
Ro-Appointment
NAME OF BOARD OR COMMISSION. Richmond-Shireds commission NAME Arranna Bedngue]
HOME ADDRESS:a.e
ZIP CODE 99804 HOMEPHONE_N/A WORK PHONE: L
OCCUPATION Student,/ Child (are pavider
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: 15+ Yar PLACE OF EMPLOYMENT: Rayite de Sol DAy/are
REASONS FOR INTEREST IN APPOINTMENT:
I have parnapated in the Fishmand Shimada Friendship (esmission an and uf since I was selected t be a student ambassador the summer + 2010. line then, I have nesten sturents st my home and hwe kept up with wins and newis by atendin the anniversary worse. I am more then willing to fully participate as a onamilsimer.
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
EDUCATION:
El Cevita Han Chall - Iomduate 2019
Lantra (usta (lege - in progrest transfer + SEIN
REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address) 1_Evan Sirchuk. (510
2. Valeria Snidex, 1
3. Lisa Weaver, S
4_C9reL Ashley
5. Natasha sekett
To the best of any knowledge the informalan gravided is true and correct Signalure 13/03/2022
Deliver or Mail to. Cily Cherk
Or Emad to. GilyClerkDent@a nchmond ca us
450 Civic Genter Plaza
Richmond, CA.94804
For Office. Use Only: New Appointment. Reappointment.
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