RECEIVED Rick
CITY CLERKS OFFICE
CITY OF RICHMOND
2025 FEB - 4BRARBOR COMMISSION APPLICATION FORM
DATE: 01/30/2025
Check one: New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION: Richmond Shimada Friendship Commission NAME: Connie He
HOME ADDRESS:
ZIP CODE: 94804 HOME PHONE: WORK PHONE:
OCCUPATION: _ EMAIL ADDRESS:
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: 22 years PLACE OF EMPLOYMENT: _
REASONS FOR INTEREST IN APPOINTMENT:
Twould like to help as a commissioner in the sister city exchange program FRATERNAL AND/OR CIVIC ORGANIZATIONS:
EDUCATION:
University of California, Berkeley
REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address)
1. Valerie Snider,
2. Liana Ngo
3. Hao Yang He,
4. Seiya Adam,
5. Jose Larios,
To the best of my knowledge the information provided is true and correct:
1/30/2025
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