RECEIVED
Clear Form Nicolera
DEC = B 2022
CITY OF RICHMOND
BOARD OR COMMISSION APPLICATION FORM CITY CLERK'S OFFICE DATE: 12/6/2022
Check one: New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION: Parks and Recreation
NAME: Samantha Ann Torres
HOME ADDRESS:
ZIP CODE: 94804 _HOME PHONE: WORK PHONE:
OCCUPATION: Teacher EMAIL ADDRESS:
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND:7 years PLACE OF EMPLOYMENT: WCCUSD
REASONS FOR INTEREST IN APPOINTMENT:
As a mother and youth soccer coach, I want to participate in planning and directing public resources in enhancing the quality of life of Richmond residents through safe parks, quality rec programs and equitable use of facilities and P&R resources.
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
Chemtrade Community Advisory Panel- since 2018
WCCUSD 7-11 Committee member- 2022
Richmond United Soccer Club Board member- Secretary
Wac
EDUCATION:
BS-Genetics, UC Davis
MPH-Genetics, University of Washington
REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address)
1. Daisy Ptak-
2. Olga Reyes
3. BruceGreenlee-
4. Claudia Jimenez-
5. Dave Bleckinger-
To the best of my knowledge the information provided is true and correct:
December 6, 2022
Signature Date
Deliver or Mail to: City Clerk Or Email to: [email protected] 450 Civic Center Plaza Print and Sign
Richmond, CA 94804
For Office Use Only: New Appointment: Reappointment: • • 1st 2nd • 3rd