Richem
RECEIVED
BOARD OR COMMISSION APPLICATION FORM AUG 1 3 2024
DATE: CITY OF RICHMOND
CITY CLERK'S OFFICE
Check one:New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION HigiNG
NAME: Eric moseleu
HOME ADDRESS:
ZIP CODE:94804_HOME PHONEL WORK PHONE:
OCCUPATION: Documentary Filmmaker EMAIL ADDRESS:
HOWLONG HAVE YOU BEEN EH GET OF THE CITY OF RICHMOND 1 year z months PLACE OF EMPLOYMENT:
am interested iN
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
Some college at los Angeles City College
EDUCATION:
Some colege at los Angeles city college
REFERENCES (Minimum 5 - List Name, Address, and Phone Number)
1. Cynthia Dellar
2. Clart Kwok GeorgetowN SC
3 EriCA mOSely SAN FraNCiSCO
4. MICHELLE HAYES
5. MyRTLE BRAXTON
othe best of my knowledge the information provided is true and correct:
i Moralle 8-13-2024
Signature
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