RECEIVED
PRINT FORM MAR 2 9 2024 CLEAR FORM
CITY OF RICHMOND
CITY CLERK'S OFFICE
Richmond Youth Council Application
Date of Application: Check one: New Appointment: V
3/28/24
Re-Appointment:
Applicant Name: Pedro Ruiz
E-mail address:
Date of Birth: Age at date of application: 17 Years living in Richmond:
10 Home Address (Street Address, City, and Zip Code):
CA 94804
Primary Phane: Secondary Phone (optional):
Name of School (if applicable):
Richmond High School
Work Experience / Volunteer Experience:
Interned at Supervisor John Gioia's Office
Volunteered at Richmond's Thrive Thursday events, Martin Luther King Jr. Park Volunteered at El Cerrito's Relay for Life event, Cerrito Vista Park Interned at The Global Warriors Summer Institute, Ryse Center Organizations, Honors, affiliations:
Center for Youth Development through Law
Re-Imagine Richmond
Rich City Rides
References (List Name, Address, Phone Number, and Email Address):
1) [email protected]
2) [email protected]
3) [email protected]
To the best of my knowledge the information provided is true and correct:
Sienature: Pedro Rviz Date: 3/28/24
Submit to: City Clerk, 450 Civic Center Plaza, Richmond, CA 94804 OR Email to: [email protected] For Office Use Only: New Appointment: Reappointment: