City of RECEIVED
San Bernardino
JAN 2 4 2025
BOARDS, COMMISSIONS, & CITIZEN ADVISORYY COUNCIl OFFICE
SOUNDED IN BUD COMMITTEES
City of San Bernardino
BOARD(S), COMMISSIONS), AND/OR CITIZEN ADVISORY COMMITTEE(S) APPLYING FOR:
1. Public Safety 3 teren Relation
2. 4.
LAST NAME FIRST NAME M.I.
MERCADO Concepaim (Connie)
HOME ADDRESS ZIP PHONE
(HOME)
(MOBILE)
EMPLOYER JOB TITLE EMAIL ADDRESS
BUSINESS ADDRESS ZIP BUSINESS PHONE
DATE OF BIRTH
Length of residence in the City of Are you a registered voter of the City Which ward do you reside in? San Bernardino of San Bemardino?
25 Years Dres 0 0 0•0'
3 Months ONo 000F
Why you want to serve on a city board or commission:
To serve my commit and prepare
them for disasters of any needs.
Board(s), Commission(s), & Citizen Advisory Committee(s) App. Page 1 of 3 Updated: August 29, 2018 What do you consider to be three (3) major assets that would qualify you for selection to this board, commission, or citizen advisory committee:
1. bilingual/I hair fast a nasties.
2. dama Communily Health Norker;- CHA; I'm a nave
3. Experience or special knowledge pertaining to area(s) of interest:
C..E.R. 7. Certified / C'PRofest And Certifed.
Exp. o/ law enforrenut
Fis ter Parout:
Participated in 7 Mission trips Abroad. (reediel)
Educational background:
A.S. Narsey
Cert. M. A.
С HW.
Occupational experience:
RPD-Traffe a crowd cretrol, citations ande
Front desk office.
Nussy- all medical backgroune
Professional or technical organization memberships:
CHN Commel.
Board(s), Commission(s), & Citizen Advisory Committed s) App. Page 2 of 3 Updated: August 29, 2018 Civic or community experience, memberships, or previous public service appointments:
OPTIONAL
How would you classify yourself? (Optional)
•American Indian/Alaskan Native African American/Black • Asian Hispanic/Latina •Native Hawalian/Pacific Islander White • Two or more of the above categories
What is your gender? (Optional)
Female •other/Prefer to self-describe
Male
Are you a person with a disability? (Optional)
• Yes ONo
Applications are screened on the basis of information submitted and may be subject to a Livescan as part of the application process.
The information provided is factual to the best of my knowledge. I understand that I may be required to complete a Statement of Economic Interests Form as required by law, and that I will abide by all the codes, ordinances, and regulations of the City of San Bernardino and the State of California.
101/24/2025
SIGNATURE
Return to: The City of San Bernardino Council Office
Electronically: [email protected]
By Mail: 290 North D Street, San Bernardino, CA 92401
In Person: 290 North D Street, 1 Floor - City Information Center, San *Attach a resume and/or additional information which you feel will assist the Mayor and City Council in their selection.
Board(s), Commission(s), & Citizen Advisory Committeds) App. Page 3 of 3 Updated: August 29, 2018