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• NOV 07 2024
BOARD OR COMMISSION APPLICATION FORM
Clerk's Of of Richmond DATE: 11-7 24
Check one: New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION: Human Rights and Human Relations Commission NAME: Xiomara Casias
HOME ADDRESS: Richmond CA
ZIP CODE: 9480 | HOME PHONE: WORK PHONE:
OCCUPATION: Highschool Student EMAIL ADDRESS:
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: 16 years PLACE OF EMPLOYMENT:
REASONS FOR INTEREST IN APPOINTMENT:
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
sophmore year of highsdool.
EDUCATION:
sophmoore year of highschool.
REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address)
1. Lucia Casias
2. Maria Casias
3. Irma Zavala
4. Manuel Zavala
5. Guadalupe Cortez
To the best of my knowledge the information provided is true and correct:
Xiamara Casias 11- 6-24
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