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BOARD OR COMMISSION APPLICATION FORM
DATE: 04/13/2025
Check one: New Appointment 0
Re-Appointment D
NAME OF BOARD OR COMMISSION: Recreation and Parks Commission --------------------------
NAME: Harlan Butt
HOME ADDRESS:
ZIP CODE: 94801 HOME PHONE: WORK PHONE: -----
OCCUPATION: High School Student EMAIL ADDRESS:
HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND : 16 years ------------ PLACE OF EMPLOYMENT:
RE AS ON S FOR INTEREST IN APPOINTMENT:
I would be interested in learning how the commission works, and how volunteering my time could have an impact. As a resident of Richmond my whole life I want to help improve our local parks and provide a younger perspective.
FRATERNAL AND/OR CIVIC ORGANIZATIONS:
none
EDUCATION:
Current sophomore at High School
REFERENCES (Minimum 5 - List Name, Address, Phone Number, and Email Address)
1. Tom Butt,
2_ Maryn Hurlbut,
3. Rosemary Corbin
4_ Susie Davis 209
5_ Eleanor Blue,
To the best of my knowledge the information provided is true and correct:
Signature
Deliver or Mail to: City Clerk
450 Civic Center Plaza
Richmond, CA 94804
For Office Use Only: New Appointment:
4/13/2025
Date
Or Email to: [email protected] .ca.us
□ Reappointment: □ □ 1st □ 2nd □ 3rd