Date of Application: Check one: New AppointmentLJ
I l/
February 16, 2025
Re-Appointment: ~
Applicant Name: Elena Velazquez
E-mail address:
Date of Birth: Age at date of application: 16 Years living in Richmond: 16 Home Address (Street Address, City, and Zip Code):
CA, 94805
Primary Phone: Secondary Phone (optional):
Name of School (if applicable):
Work Experience/ Volunteer Experience:
I
Bay Area Girls Club since 2013, The Latina Center participant of severa l programs since 2012, Participant at Boys and Girls Club 2022 Rosie Girls Summer Camp from Rosie the Riveter Trust , comp leted Urban Tilth' s 2022 and 2023 Summer Youth Apprenticeship , The 3rd Lead for Urban Tilth' s SYAP 2024, comp leted NorCals First Alarm Fire Camp for girls in 2022 at the Oakland Fire Training Center, comp leted NorCals First Alarm Fire Camp for Girls in 2023 in Dixon, the Engagement Coordinator for the Highschool Student body in 2022 Organizations, Honors, affiliations:
Bay Area Girls Club, The Latina Center , Sisters in Solidarity Womens Event, Urban Tiilth Bay Area Girls Club, The Latina Center , Sisters in Solidarity Womens Event, Urban Tiilth References (List Name, Address, Phone Number, and Email Address):
l}Miriam Wong, Richmond CA, 94805
2}Brenda Ayala Roseville CA 95661
3}Nelly Velazquez Richmond 94804
To the best of my knowledge the information provided is tru e and correct:
Signature: _ f-_~ ___ )lj_ ~--~----L-~- ------ Date: 02/16/2025 Submit to: City Clerk, 450 Civic Center Plaza, Richmond, CA 94804 OR Email to: [email protected] For Office Use Only: New Appointment: D Reappointment: D 0 1st □ 2 nd
□ 3rd