f.;j City of Appllcatlon
~ Santa Clara
-,.•l•••••I .. ~., •"• I •
Position
Bo.lrd I Ccrrvnl_,on / CommlUco Appli,1 ng for.•
P""5 & lb:rootm °"1Ynl .. lon
Persona11nform:1tion
/VO \'CU• roglllorod vOCor ond roli<lonl tho Clly oc·s.nb Cl0m7' p,\Abe•~•.-.d-.dlfll l ll'Wd Wicalion)
I" Yes
Adllrc••
Sl."NtMJ M
~U••2
°" s.r.co Ooro
l\>c,1/ l) pQ,,lo
IJOOGI
emou•
Pr1m:uy Phono Nl..n\bar•
Soconclory Phono ltlmbor
Pro-,ldo 1Wolcon1of Proo! of Rolidoncy lnlho a1yo1 Sonlll aor., (~\Ill boorcsldcrt d lhocityd101Ueln CII llfl'O ol(ll:fl,c.-,llcn) Atbchn,on1 1•
S0\11• Ol.pdf
Albctunont 2•
:10Zl1200-SCU 1"'1n20:wl>I r.<I
P,o..,n1 Employer'
Sdl
Job TIUo'
OCllo Selorli$1
Work Experience
HJvo you ottondod o moo Ung of Ulla Boord'Commlrdon ?'
r, Ye, r , No
Provlous Govomrmnt Bodlos/ Elccllvo Offices Appllcan1 has served Gowmmont Oodioa' Elcctiw Officot:
Row
Civic or Charitable Organizations 10 which Appllcan1 has belonged:
OYlc ..- Chor1bblo Orgonlutjons
Al)',O, lho toMl d a.,pet1or<> 1111\ Schec(s 8'r'd ond CdCl<O,J.)l'd '-It< ch.Yttollie orp.,,,1Z.1Uon l:lr tho p,sl 7 yo.n
I
ROW err 0<111<1-et< 01 11,e sarco OM> SN'ICXl!IO H.l'dl Ch:villlblO IMl'IO 1Cf 10 yo.n now.
2 ~. I bmod1hoN!iitoorv.olch 9""41 lcrmy OClgmtiood OS V.0\""1lCl<pai~ pcllY b\illlMOI f o,garriOd Clll lho roigl"ccn ard ln.ltOd S;w,lo Cl.YI', tho pejlco clllc<n lo ~~CO .-en1o1'°" A, en etg.niOd~ Y.., ol ~"'7-Y COOh Clhe<, "1f neigl'l)OfhOO<l 1$ vr:,y &o!oroNMd v.on,,0 no1 <lq)Olloncos M/"""' c~.
~I Comor&lono(YMCA lnll,111\0) · Thcl)n)gllfflerYIIIOo'I ','O\Ah bcl \1WCd. ~pcc lOd, ilf1d kno.m«> 1hc:y go,,lnlo hoam,,. cmlng. and ro,pr;o,itlold.! 1• • •
Special lntorom, Hollblo1e<Talonlt
G.'.rtl:rirQ, KkrQ. 1/l•lc. To.xNrlJ. Prcblcm idlO'. Em CI\J;,1 1ic:, College, Professional, Vocallonal Schools Allend
High School, COllogo, Profollionol, Vocofono l S<l,ool
l.l>IOIIII)' ol Qirlorrla. Bcrt<doy
Special aw4nlt or rccoonlijon ,ocolvcd:
Pukknf• '™1Fd for bool c,rcjoyco o1 Porto! Soll\\~ . O.!l)Cllna. <:1, ~1 JTKB
4JSS2KB
Potlllonl Offico Hold:
P01Wo1~1j Hold:
Ccrpomlo M,l1ch0\'.><1PatOCTrcmi,rc,) INY.>cdCClcd mere 11Gl 20Q< ln<l0Miion...ef.,,. yoM .,, CHS 8'r'd ard {;de, iµYII. IO,,,,.. ~\O ,,_,..con"""""". In"'' ed.r.111,onol ond rcctDOl>CnOI oclhliy.
P"'!1M' c:io;r,iz«
I omrooi,:n!tio UQllirWOQm an.r-' O\Crt (hddln/\ugJs~ScpC,:<nbc,)U.,l ls oUcrrdOd I>/ eco-1000 f)Cqllo """'Y yo,,. I how been C<gOn1lng k ltt lho pa,18 yecn ro.vcrrd i:f M to cc,1....,001,ig11.
Block Copl.-.fl(l'rcoool)
r orgorlzc N:I~ N\Qhl~ ar-d oche<~-iono
D.lll'Q Co,Jd. Seri<tCIIOZM! f0 "1f~l1..,,..,s.,fl> ordlm~bocruso\\eusocf 10 do o1 ihdr 1h<l:1>1ngond cl\."Ckoooothcm ton-d<o 1111> lhoy_,,dol~\\tl l.
Assel O\:ln'l>crr (8 vo,t'$)
1,\Cll1<b:I ,.,u, }""°9 11..:xnt& ard I~• 1hcm h>.v10 told heolllly &OCl.i ond cm:cJcnol akils crrd b<h.'ticn I l"'!lhl them locl• lo O.atemO oofl dldx ond lfvlw M>Jor SIJbfOCI
~•Sc:lcnee
D.lto
0.,10
3'212024
3'2/2024
l'-..3
c:> ,....,
.r:-
:x
:cir,-
:::c,
I
U1
:x:-
::i:::
<:=?
w _.
611!112017
0.,10
8122/2023
Plon10 u:uo re:u,ons wl'rt you wont to beccma n mambor of m11 SoordJCornmlmlorv'Commlttoo, lncil.Kfjng whJ1 lp(ldflc obJactlvo1 you wauld bo woe1clng toward 01 o mombor ol lhl101Maory bo-:ard; (-)
-q
... ,~ c=; -1 . ,, ,
::') 0
, 1. II
)
· ,r . ,,;,
--1
- ,""' Jc, -, -' , .. --:o
' I
_..._
As a Santa Oau res!CV&it fee 22 yc"BfS rcN. I 00',.e .::rttertded s~ pa'r; iJf"O rec. ev~nts. faery time I \~sit a pc1fk, I ifrank the Q"..00 citizer6 d Santa Clara v,ho \dunteer on the Par'r( and Rt.-o.c-s b:J.Jrd and p;Jssicrutely wotK h:1rd to make it so w:,r;doiul.
As much i35 I Ja.e o..JT p;J(,;.s, tlltfe are mzny ih3t can use a httle la,e and care. t,lany of them .3re dd aid dated. I 'I.ant to our rJKs to be m.--ire ff'Cdffil ,..,b....--:re cur cti\ll;;fSe oc~fhtahocd ccmmI1nitles CJn gather md cclcbrate_ Any other information which you feel would be useful to the City Council in reviewing your application:
J run an e,:ceHfflt caT111!.Jfirator nnd .:1 pec,Pe person. With 25 yea-s ct COiJXrate exp-::fie:nre. I use OOtl to J11J'.~e c{iectl\e 6ecisicrt I am 'BY crg.J.ni:zed and deta:I &.entect I am catfl:n th31: l v,,11! be an a.."Sc{ to your tt:"{lffi.
Ne you associated with any Organization/ Employment that might bo deemed a conflict of interest in performing your duties if appointed to this position?* r~ ~~
City policy directs all advisory body rncmlxlrs not to vote on matters where there exists a potential conflict of interest Would you bo willing to abstain from voting if such a conflict arises?* a= r~
Signature
Date
3!2i2D24
~
City of Appll catlon
Santa Clara
l••C-•Hl"' Mll\;••·U•
Position
eo.,ru I eonuntealon ( Com1nlltl.!e Applying for:•
Pi)l(s & RoctMtlcn c«mir.Sion
Personal Information
N.ln,o"
P,,t<1d< Cla,y
NG you a roghtorod voter ond r(lflldont lho Cliy ot S;intn Clora?' ~\j?j bl fl,NQIH,"9(.1\,('l(O,U lttt\lOfG"-4JGJl-(lfl)
(7 v ..
Addro&S
1 llMt M l>ol
IJ..rf._lJM,
c1,;
S#'laClom
1'1Jil '""'~
oc,()50
£111011•
Primnry Phone Number'
Scoo11d1ty Phouo Number
Provtdo two roma of Prool Q( Roddoncy 1,, tho City <1f SAnlo anr-a (Mu~• booreoldort oru10olty ,h.,,rtoc l.,. lit 11moort!l)t'Jl1catlot1) Alll~hmonl 1
111
lnago to POF ?0240019 16.62.33.pdl
/.J.tiic:hrntnl 2•
11"'11() 10 POF 21)2,1(1310 16.50.00.pdr
PfOIOOt enploytr ..
Gc,o,Jo
Job TI110•
PIC(l,,(lt 1Mi1gel'
Work Experience
H,'\vt Y(KJ 11tondod :1 intt llng Of ud, Boart1/Comml«Jon1• r~ • m
Previous Government Bodlos/ Elecllve Offices Applicant has served Govomment 8odlotl Elocliw Offlc:.1
Civic or Charitable Organizations to which Applicant has belonged:
Qvlc or Ch:u'ltnbl& 0rgar•11tloos
llb\VJ
Spoclol In .. ,. .... HobblH or Talonll
Aoc00$lbil1ly OXJ)M. f)'Odua m .. ,agon,ont. eu1c10, ..... \ <,sglo ,0eu1.
Collage, Professional, Vocallonal Schools Attend
~lgh School, Coltnye, P,o,feMo,111, Vocatlon11I Scl1ool uii\Clf'1ty or Cdomclo 01 Batck1
Ui1<.'<$lly Of Cclorooo, Bou:lc<
<Jamerje MdlonU'll""11ily
S1,telal award• or rocognltlon r4t.alwd:
~l.tnl fll9",!1"W>'ll\)gl,,n
CA
r.,,.;Alft
USA
Po<IUo,1/ ornco ltolcl:
Poil Uo,1(1) Held:
M~Jor SubJecc
9.Ch(IOI of SCIO/IC&, con-c,.Aor sdMOO
Mos tors or ~ng. ccn'(Mcr ,e,..,..
Mas11n or B"'"""• inriristmlicn
I.COMO
00.61KB
o.,.
Doi•
◄ /112005
411/2000
4/112011
,..., = ,...,
.r-
::r:
:s,-
:::0
N
C)
:?>it
:JC
-.J ..
c..)
....J
PltntJO Ute r1uoo1why you war,1 to become a ,nenll,Mr of this Bo:ll'dlCommhiSlonlCornmltuio, lncluelh,g whot tptdfic objadvo1yo u would bo wnrtdog tow-a rd H l'I mombor or U•lsadi.4eory b08rd:
llo ol"")'tl hod o kMI or 00:door rO<roallot\ , 100~ t(tn n1no.1.h OS o lloy scoot vJ,oro I r<lOChCd Ul& """' cl MIi• Seo.A. Since rnc>ing to s.,..., Oin, In 2011. !lo leken -ago cl U10 lcic.i PM<S end rocr«lliOM acl\\lllM. As a IMIWOl• •·v«-<ld di!Oi11l4Y. Ml<>.•dJ'1111cipollngln l\10 tlil<tm l:ltl.J>Od ....... 800leNc«1 lh,1I lhopo,1(8 e;dfllCgrCUl)mokto ~ ..
PcrsalOlly, a, a d'6ablod _,"louses rnt,eelc\"11r, rm''" -• for ecc,,..A:ltny 11-.:I vJ1h to ooo v.hJl lovoods I con rreko 10 c11s"1ncJ PoCl)le \'Jlh <l,oUJ,llot 11\l ~od In o.r lood 1paeee.
WrJA l<bl'\ hMr,rOlkAB oxPtwlancoC/1 nd(y ccn·n1.,1on, 1 amacµck te;w,1Clf, Ol'dll'ilts •n1100 lmtoo1<1t>;ttogn,, inlo. I Ml ro,y to v.ok v.1111. get rla,;iv.dlv,I U1otherl)OqJo, deda~M<lcdlllloml l"'- rm lcd<lngloMMI toM!OlrQ"-"'/0 1 CMmokoo.r PM<ao'd - ia1 w,i ... enJo1nl:lo"'d .,..t,A b'Cl<)r)O>O. rdl.., lO tlf<•"""' 1,u~sco1w1tsla1 w w:,1< 10\n~.,,.., M:I giwoock 10S11n100.rnl "''" olher lnfonnatlon which you feel woutd bt uniohll 10 th6 coy council In rovfowfng your appllcnl!on:
r ~
"c, ...,_
;-:j-l
,-<
--, c, ,-,,
'ft
·. 'l, •
;.,;
.,-1 -> ~n " r ., ~ -~ T·,. .,.
Are you associated wilh any Organization/ Employment that might be deemed a conflict of interest In perfonnlng your duties if appointed to this position?* r Yes r- No
City policy directs all advisory body members not to vote on matters where there exists a potential conflict of Interest. Would you be willing to abstain from voting if such a conflict arises?* r Yes r. NJ
Signature
Date
3119/2024
~
City of Application
Santa Clara ,,~C'-... , fl~-1 ..... , .....
Position
llonrd I C..11n1IMon I C:ommlttco A1>plyl1,g roe.'
P~• & Rocroalkn Com'l•ilcn
Parsonal lnformalton
Alo you o 1ogl1torocl volt.r ond rellidant U1e Clly at 9,11nta Cla,ro?' IN·t ~ • l'lqt111\;d\(l(!JI Al lllli'lt ol CIU'IIWl~•ll f' Ye.t
Addrus'
&we<M-
MnllliUl">f2
0 1)'
Sa-taOom
1-loJ)t~pO)lit
E<i00(),33l2
Sooo11dilry Phono Number
Pt0\Ado two rom".of Proo f c f Rt !fdoncyln tho a ty of Saota anra ~hJSI llO o '""""'" ol 1ho cily of•"'• tlom III llmo of fjjlpitatlon) Altnd11n t nt 1•
oStnitJ!024-02~too.p,Jr
All.:lchmant 2•
OoMatco Uccnso.p(Jf
Prot11ml 6nptoyu *
U-i\(fl\ily d Cnlibrlo. S«la Ouz
Job Tlllo'
O.,'l)Onn""'1M,rug.Y
Wor1< Ei,perlence
11:ivo )'OU attended II moolnocl1 hlt8oa l'd/Commlul,on? ' r~ "~
Previous Govemmenl Bodies/ Elecllva Ofllcos Applicant l"18s served Govammont Bodin/ Ooctlvo omcos
Rb\Y
Civic or Charitable Orga,1izalions to w11ich Applicant has belonged:
Civic orChoriU.I~• Ol'gorlt•llon,
Row
6poclal Int.ore• Hobbfos otlt lonu
College, Professional, Vocational Sdlools Attend
Hgh 9d100I, Colltgt, Po,fctl'io11nl, VocaUonJl SdlOcl
W"lr,/J SUJIO U,-,nily
Spada.I ownrd1 or rtoog nltlon rocolvod;
£11'.A/ " V'.fr,'Jl/l\)!1 QI\
CA
C:,,.,ot.f(
USI\
PodUon/ Offtto Held:
Podtlon(a) liold:
Malor SubJ1t1
Phy,llco. Edvcl<ioml l.ead<nHp & Mmrl•trlll/c,\
D.>IO
Dalt
PloaM 1t.,10 roasonswhy you want to beoomo o membor or 11111 ao.,rdJConnf'll•fonlC,omm1ttto, lnc;;lutl/ng whnt apoclnc obloQJvuyou would bo '-NOrf<h'iQ toward 11s o mornl>Ot of d\1!1 ad~IOfY l>Olrd:
I 118'.!)ll'.O)'OJl'Oklcls, end I l<M ._.edn'<l•1Y Olll 10po,11$ lnlhocky. 0,-1;,mily af!IOUSOS ,,....,.,o11ho cMy rocroalionfl"lO'iYl\S, ond I Uirl< loould h:.M ldpU p,npocllw IOWOl'<lh l- ornie p0/1< 1111d «IC Oll)(lli lOlkl\.
,...._,
c:::,
r-.:>
..i::--
::i::
> :::::0
N
"1:1
'.:I::
z:-
c..n
+"
/V1y other lnrom'3tfou which vou reel would be uMn11 to Ulo Clry Council In rovlawlug your e:pptlcetJo11:
I hi,,,) ;.-eny Y40II of ldl.lllW 00.CCOCY IIWl')Jgll "'f Y-')fkpl806 \\ll(YO I ha\()·"""" ... !)(>"'1JI nl('ll1)0, .. y,:~ ... (joctod lood<Ythlp p;)Oili0r1$ of alal o-garlzallO>I at my locol CM\llUS Otld """' ' tho UC $yGl<lf11, I !lf1\ 11lmller\\llh ..,nru, llyloo af n.J«ing "'°"in•1-• on:lgfllll)!I. I om1mof1. ~'lfd,l<)ldng. endv.<>ll lol>lrQmy~ tomydly.
Alo you auoc:lotod with nny Otga11lutlor\l .Emplo~·ment that rnloht bo doo1net1 a co,,fllctot lntereu In 1>0rformlng your du Ilea U appolnlod to ttit,poti dor1?• r~ r-~
City Pollov dlrot1.1 nu uMeory bOdY mtmbol'1 no110 voto on matters w1,ere t11oro •>dltl fl po«onllnl conmc.t or llltorea. Woutd you bo wtlllng to al.>sanln from vodng If sud1 a conflict :ufeos?~ r- Y41 r ~
- 1
-,£:2 r--;~ ,·<
.-in
• ' - 1
' ...
\ .. ':
--1 , >
J.., .... -
("")
" -- :=;,
'. 1 . ...
Date
1112/2024
(l'.' -:\ City of Appllcatlot1
~ J Santa Claro
- .............. .
Po"llon
lloo,d I eo..-n1a1on / C..n111l11to llpplytng ror.•
P-1<1 ~ Aoc:notlcn °"""'" en
Per~ m,11 lnfoumt 1on
Nnm••
o.~~d 1-IJ),.,
1w you• rtgllltrod YOCor and rHldtn l u.e aey of Sanu C.ani? "' t-'11 ► ' ".J" 4\IIW,...,.,u,,., 1 ~••
"y..,
M.n•ll"-1
o,,
s.naa...
,w ; ,zi,Co.._
9$051
Seconctuy Phono NumOOr
P.-..ldt two fonnsof Ptool c l R1.d1n<yln Utt Cltyol81n13 Oora (Multboo...-dd,0<1 1yd1_d,..,."'""d~I
AllacMlent 1
1 IMG_SS-ltlpcf
Pro•nlEi,lfll.,..r'
tlald 1~ P1rt1W1
Job Tille•
UlOlllO)'lMd
Wo,k Exp,•1 cnce
1t,y0 you oHtndtd • meodna or ij1l1 Bol-ml•on? '
"~ ~~
Previous Government Bodies/ Eloctlvo Orficos Appllcanl has served Gowmmtn l Oodl1f/ 0 .al\19 Offlc.1
-A,,Jtw0itm,t1 ..
Civic or Charitable Organlzallons to which J\{)plicant has belonged:
Ovlo or Charltnblo Orgt1nlu lloo1
ifd(l(J s~ (S111de,• l-blllleo• NIIW..I
-.v.1oyYCM11Clamll 1 ""1""
2 Spodot lnlt- Hobbltto, Totonu
Collego, Professional, Vocallonal Schools Allene!
Hgh School, Coll1111, "'°'··-'· Voc.Uoml 8<hool
Slrlo On Hd• Sch:ld
S&n.t>u&attuwntty
Spocta l ow1rd1 o, rocoanllloo roo,lved:
Po,fdonl Offl• Htld:
~-b'OMcl4
Pooldo11(ojllaldt
MMil«
Ntn1.,oJ
471,11KO
t,t2M9
RECIEVED
MAR 2 2 2024
City Clerk's Office
City of Santa Clara
Dito
DA PolUCl4 Sdor'fC4. o.i, uudt. Clra<Nalod Ooeent>or2020. OoM's&hclarFill ~ ... ,.,201eondSplr9 a.m..,.,:mo_ l'lfe■ldort', Schd,rFIII s .. ,,..,.,:7020. Son.Joie S!Mol.t"'°""'Y, Son.Jose, CA Plouo "-'" ,. • ..,..wll jfyollWlnt tobooomo • 1n11nborol thl1Boo~ ,.nlorlon/Coovnllloo, l11dll(ling Wllal-ftoob)1diw1youwcv ld bl wootdng 1ow1rd HO m1mborol lh\11cM110<Vbolrd:
As a lifelong Santa Oara resident, I k>.e our pai1<s especially Central Paik wr crow je.\€1 and the pa,k by my house I ofien walk lo. I always go lo our annual art and \'.ine feslilBI and the annual BBQ in Cootral Pa,k My specific otjeclil.es w:xJ!d making those e.ents &.en belier by increase the range/di""5ily al booths there especially fc, the art and ,•,ine festhel, partnering \\ith lccal businesses and nonprofits to promoted said small businesses by ensuring they ha\e a piece in such €\alls especially the art and vJne fesli\01 and \\ilh nonprofits promote them so that the people al Santa Oara can be more exposed to more ,1oohy causes and prO\lde mire ccmnunity sef'Jce opp::rtunities for oor citizens, BOO last but not least get more e\611s in OJr parn:s. A more specific d.iecti\.e/coocem fcr us \1.oold be ensuring the future of chldren's th'>-...atre gii.en haN the pandemic lhreataned its Mure and ha\lng Mends v.ho did that du!ing lhair c11ildhoods, I know Ix,,; piceless it Is to our city/ccrnmunity and the irnpalance of ensuring Mure geooralicos ha\e Iha same q,portunities from it, We shoo!d also pr emote it more. Sadly, I didnl really hear alxxl\ it until 11igh school so I sadly didnl do il gro.~ng up.
Any 0U1er Information which you feel would be useful to the City Cou11cil in reviewing your application:
Ne you associated with any Organization/ Employment that might be deemed a confiict of interest in perfonnlng your duties If appointed to this position?* r~ c-~
City policy directs all advisory body members not to vote on matters where there exists a potential conflict of interest. Would you be willing to abstain from voting if such a conflict arises?* c-~ r~
Signature
rP',µ-t.l., ~
Dale
3'2212024