BOARD OR COMMISSION APPLICATION FORM
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NAME OF BOARD OR COMMISSION: _____________________________________________________________ NAME: ______________________________________________________________________________________ HOME ADDRESS: ___ __________________________________________________ ZIP CODE: ____________HOME PHONE: ___ ______ WORK PHONE: ___ _________ OCCUPATION: _______________________________________ EMAIL ADDRESS: ________________________ HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: _____________________________ PLACE OF EMPLOYMENT: _____________________________________________________________________ REASONS FOR INTEREST IN APPOINTMENT:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ FRATERNAL AND/OR CIVIC ORGANIZATIONS:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ EDUCATION:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ REFERENCES (Minimum 5 – List Name, Address, Phone Number, and Email Address)
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2.____________ ___________________
3._______________ _______________
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5.__________________ ________________
To the best of my knowledge the information provided is true and correct:
_______________________________________________ ____________________________ Signature Date
Deliver or Mail to: City Clerk Or Email to: [email protected] 450 Civic Center Plaza
Richmond, CA 94804
For Office Use Only: New Appointment: Reappointment: 1st 2nd 3rd Human Rights and Human Relations Commission
Rabia Berna Atik Watson
94803
Public Health Professional [email protected]
19 years
California Department of Public Health
I immigrated to the USA in 1995. Before I moved to the USA, I worked for improving foster care children education gaps, advocating minority rights and helping with refugees. When I first moved to the USA, I worked in UC Berkeley, Human Rights Center to work with refugees and asylum seekers. I always had passion for listening and being the voice for who are in need, who are one reason or another excluded, pushed away. I want to bring my passion and experience to my community.
California Association of Professional Scientists, ABD-ANA (Turkish-American Mothers group), Bay Area Turkish American Association, American Public Health Association Istanbul Medical School
UC Berkeley, School of Public Health
Ozlem Guclu,
Esen Aksoylu,
Nalan Hodoglugil,
Sibel Demir,
Tayyibe Kizir-Dundar,
May 2, 2022
May 2, 2022
RECEIVED BY
CITY CLERK'S OFFICE
MAY 2, 2022