FOR THE COUNCIL MEETING OF JULY 19, 2022
COUNCIL AGENDA REPORT
TO: City Council
FROM: City Manager
Prepared By: Chief Deputy City Clerk
SUBJECT: ANNUAL JULY APPOINTMENTS
RECOMMENDATION:
That the City Council make appointments to the Block Grants Advisory Committee, Central Coast Commission for Seniors Citizens - Area Agency on Aging, Library Board of Trustees, and the Santa Barbara County Library Advisory Committee; and direct staff to continue advertising various Board and Committee vacancies.
BACKGROUND:
Vacancies currently exist on the Block Grants Advisory Committee, Board of Appeals, Central Coast Commission for Seniors Citizens - Area Agency on Aging, Library Board of Trustees, and the Santa Barbara County Library Advisory Committee. For each of these vacancies, a Notice has been posted as required by State law, and other noticing has been provided on the City's website and through media resources. It is the policy of the City Council, per No. 88-2 adopted May 17, 1988, to appoint residents of the City. The filing deadline to receive applications was 5:00 p.m. on July 1, 2022.
DISCUSSION:
BLOCK GRANTS ADVISORY COMMITTEE
This 15 -member committee assesses the community's needs, conducts public workshops and hearings, reviews applications for funding, and makes recommendations to the City Council for the allocation of funds under the Community Development Block Grant (CDBG) Program and the HOME Investment Partnerships Program. Applicants should have an understanding of housing and community development needs and a knowledge of or background in providing human services to the community. The members are nominated by individual Councilmembers, appointed by the Mayor and confirmed by the City Council.
The Committee meets the second Monday of each month at 5:30 p.m. in the Community Development Department's Conference Room.
Five vacancies exist on the Committee. Five applications were received.
Three applications were received from the following Incumbents:
Incumbents Previously Nominated by
Rosalie Marquez Cordero
Tim Seifert Patino
Jason Tamura Escobedo
Two new applications were received from the following:
New Applicants
Hugo Canton
Blanca Mejia
Councilmembers Cordero, Escobedo, Soto, Waterfield, and Mayor Patino will each have the opportunity to nominate one member for three-year terms ending in July 2025.
CENTRAL COAST COMMISSION FOR SENIOR CITIZENS — AREA AGENCY ON AGING
The Board of Directors is responsible for the Commission's operations, including policy setting, allocations, and personnel for the Central Coast Commission for Senior Citizens.
This includes the programs sponsored by the Commission, such as Area Agency on Aging, Health Insurance Counseling & Advocacy Program (HICAP), and Senior Information & Referral program. This Board serves Santa Barbara and San Luis Obispo Counties. The nomination to the Board would be for a term of two years which would begin once appointed by the Board of Directors following the nomination by the City Council.
A new application was received from Nancy Crawford, who is not a resident of the City of Santa Maria. However, the Board provides a very focused service to seniors, and her application indicates her educational background and experience is in the area of older adult mental health and in nursing. The City Council may want to consider this applicant to serve on this regional Board despite the existence of the Council policy of only nominating City residents to Boards. The City has not had a nominee to this Board since July 2017 when the seat was last held by Beth Keiser.
LIBRARY BOARD OF TRUSTEES
The Library Board is a five -member body authorized by State law which advises the City Librarian and the City Council on library matters. Applicants must be a City resident.
Members are appointed by the Mayor and confirmed by the City Council. The Board meets quarterly, the second Tuesday of February, May, August, and November at 1:00 p.m., in the Library Conference Room. Three vacancies exist on the Board.
Two applications were received from the following Incumbents:
Incumbent Previously Nominated by
Charlie Baker -Boyd Patino
Helen Galvan Patino
Three new applications were received from the following:
New Applicant
Randy Jackson (Received after the filing deadline of July 1st) Hunter Jameson
Julie Weaver
2 Mayor Patino will have the opportunity to make two appointments for terms of three years each ending in July 2025, and one appointment to complete an unexpired term ending in July 2024, with all appointments to be ratified by the City Council.
SANTA BARBARA COUNTY LIBRARY ADVISORY COMMITTEE
This committee reviews and maintains the master plan for each County library service zone, makes recommendations to ensure adequate library services to all, determines the per capita level of service, reviews budgets, considers site locations and building programs, reviews the operation of the library, and so forth. This Committee meets quarterly on the 3rd Wednesday (March/June/September/December) at the Cachuma Lake Recreation Hall at 10:00 a.m. The term runs concurrently with the Countywide library contract, ending each fiscal year. Nine members are appointed by the County Board of Supervisors. The Mayor nominates one member to be ratified by the City Council.
One application was received from the following Incumbent:
Incumbent
Betty Gunn
Previously Nominated by
Patino
Mayor Patino will have the opportunity to make one appointment to be ratified by the City Council for a term ending in July 2023.
Members of the Block Grants Advisory Committee and Library Board of Trustees are required by the Political Reform Act (Govt. Code Section 81000-91014), and the City's Conflict of Interest Code, to file Statements of Economic Interest, Form 700, disclosing personal assets and income within 30 days of appointment, annually thereafter, and upon leaving office. Board Members must also disqualify themselves from participating in decisions which may affect their personal economic interests. Statements of Economic Interests are public documents and may be inspected by any member of the public and copied if requested. The Fair Political Practices Commission (FPPC) is the State agency which interprets the law's provisions.
Copies of the applications may be obtained from the City Clerk's office upon request.
Staff will continue to advertise Board and Committee vacancies until sufficient applications have been received and any remaining vacancies may be filled.
Impact to the Community:
Having members of the public serve on the City's Advisory Bodies provides a positive impact to the community, enabling the City to obtain input from all segments of the community and ensures that the c mmunity receives information regarding the activities of the City's Boards, Co ees, and Commissions.
RHONDA M. WHITE, CMC
Chief Deputy City Clerk
Attachment — Applications
3 City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 3, 2022
Application Type: Block Grants Advisory Committee
CA -22-002
FIRST NAME: Rosalie
LAST NAME: Marquez
PRIMARY RESIDENCE: , Santa Maria, CA, 93454
PHONE: 8059254077
EMAIL ADDRESS: [email protected]
YEARS OF RESIDENCY: 47 REGISTERED VOTER: ❑O Yes 0 No
EMPLOYER: Retired Court Administrative/Executor -North County Courts
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: ❑O Yes 0 No
EDUCATIONAL Associated Arts Degree and attended Cal Poly BACKGROUND:
OTHER RELEVANT Former member of the County Commission for Women; Affirmative Action EXPERIENCE: Commission and Court organizations -Southern Court Administrator.
Former member; Santa Barbara County Executive Association; Santa Maria Legal Secretaries Association; State Judgeship Needs Committee appointed by the Chief Justice
CIVIC OR COMMUNITY Former Chair for the County Women's Shelter; Cecil DeMille Committee; INVOLVEMENT/GROUP Former Chair for the Santa Maria Wisdom Center; Past Director -Friends of MEMBERSHIPS: Hearst Castle; Pres and VP of the Filipino American National Historical Society -California Central Coast Chapter
0 Yes O No
REFERENCES:
Name Address Telephone Occupation
Dn. Dennis Pearson 1168 E. Hermosa 805 886-3734 Retired CEO SB Co. Fair Joe Talaugon 4579 11th St, Guadalupe 805 698-6982 Pres.Filipino American-
FANHS-CCCC
Rosemarie Thomson 916 Nan St. 805 922-2404 Retired Teacher GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes, every month since 2016
What is your understanding of this City Commission/Committee/Board? This committee is an advisory board for City Council in making decisions as to the qualifying non- profit agencies to receive funding for their respective programs.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
Yes, Block Grants Advisory Committee since 2016
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
903 North Bradley Rd
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
None
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually onor before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
Is there anything else you would like us to consider when reviewing your application? Volunteer Financial person for St. Marys Church handling the bookkeeping and budget.
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, 1 am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
I IAGREE
Rosalie Salutan Marquez June 4, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 20, 2022
Application Type: Block Grants Advisory Committee
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
ALTERNATIVE PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
EMPLOYER:
Tim
Seifert
1022 E Butterfly ct., Santa Maria, Ca. , 93455
805-680-7147
805-361-9410
[email protected]
34 HighCraft builders Inc.
CA -22-007
REGISTERED VOTER: ❑O Yes 0 No
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE:
EDUCATIONAL High School, continuing education
BACKGROUND:
OTHER RELEVANT
EXPERIENCE:
CIVIC OR COMMUNITY
INVOLVEMENT/GROUP
MEMBERSHIPS:
REFERENCES:
Name
Mike Gibson
Frank Ortiz
Kevin Walthers
❑ Yes ❑O No
❑O Yes 0 No
I have served on this committee and understand how it works Member Breakfast Rotary. Volunteer S M YMCA, Planning Commissioner City of S M., S. M. Board of Appeals, Member of the Elks Lodge, Tri valley Modelers, Member Chamber of Commerce, Member S M V Contractors Assn.
Address
Orcutt
S. M.
Orcutt
Telephone
805-680-0071
805-451-7603
805-868-9651
Occupation
Banker,ret.
Fire Chief, Ret
Hancock College
President
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
CDBG, Yes I have been a member for, 12 years?
What is your understanding of this City Commission/Committee/Board? It is made up of 15 members. Its duty is to distribute Hud funds to deserving non profit and organizations worthy of supporting.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
CDBG 12 years ?, Board of Appeals 8 years?, Planning Commissioner 6 Years
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
1022 E Butterfly ct
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
N.A.
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
O IAGREE
Tim Seifert June 21, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 14, 2022
Application Type: Block Grants Advisory Committee
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
EMPLOYER:
CA -22-004
Jason
Tamura
310 E. McCoy Lane, Unit 9J, Santa Maria, CA, 93455
805-345-5370
[email protected]
9 REGISTERED VOTER: 2 Yes ❑ No
Urban Planning Concepts, Associate Planner
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: 2 Yes 0 No
EDUCATIONAL
BACKGROUND:
Bachelor's Degree, Humboldt State University, English
OTHER RELEVANT Land Use consultant
EXPERIENCE:
CIVIC OR COMMUNITY Block Grant Committee
INVOLVEMENT/GROUP Leadership Santa Maria Valley
MEMBERSHIPS:
0 Yes 2 No
REFERENCES:
Name Address Telephone Occupation
David Swenk 2624 Airpark Drive 805-934-5760 Urban Planner Bonnie Wolf -Moss 2081 Beach Street, 805-714-5838 Santa Maria School Oceano District Librarian
Tim Seifert 2353 A St. 805-361-9410 Construction
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes, member since 2017
What is your understanding of this City Commission/Committee/Board? Current Vice Chairman
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
Block Grant Committee Vice -Chair
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
310 E. McCoy Lane, Unit 9J
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities. none
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE IF
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, 1 am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Jason Nobu Tamura June 15, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 16, 2022
Application Type: Block Grants Advisory Committee
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
ALTERNATIVE PHONE:
EMAIL ADDRESS:
EMPLOYER:
Blanca
Mejia
215 N. Lincoln St., Santa Maria, California, 93458
(805)925-2611
(805)868-3523
[email protected]
Twitchell and Rice, LLP -- Attorney
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: ❑✓ Yes ❑ No
EDUCATIONAL My educational background includes a Bachelor's of Science in BACKGROUND: Criminology, a Master of Legal Studies, and a Juris doctorate.
CA -22-005
OTHER RELEVANT
EXPERIENCE:
CIVIC OR COMMUNITY
INVOLVEMENT/GROUP
MEMBERSHIPS:
REFERENCES:
Name
Vincent T. Martinez
Lynn Limone
Stephen Wagner
I am an Attorney in the City of Santa Maria.
❑Yes❑O No
I am involved in the Board of Directors for the Family Service Agency of Santa Barbara County and in the Board of Directors of the Orcutt Children's Art Foundation.
Address
215 N. Lincoln St.
215 N. Lincoln St.
Telephone
(805)925-2611
(805)925-2611
(805)550-1200
Occupation
Managing
Attorney/Partner
Office
Manager/Paralegal
Attorney/ Professor
Collogue
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
No.
What is your understanding of this City Commission/Committee/Board? My understanding is that it is implemented to work for the absolute benefit of the community and for all of the community needs as they arise.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
No.
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
1221 E. Rice Ranch Rd., Santa Maria, CA 93455
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
Family Service Agency, Board of Directors
Orcutt Children's Arts Foundation, Board of Directors
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE x❑
Is there anything else you would like us to consider when reviewing your application? It would be a privilege and honor to join the Block Grants Advisory Committee to help contribute to my community. I was raised in Guadalupe and Santa Maria my entire life. I love my community and would be honored to get the opportunity to serve in this capacity.
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, 1 am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which 1 have submitted this application. understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Blanca E. Mejia June 17, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
BLANCA E. MEJIA
215 N. Lincoln St., Santa Maria, CA 93458
(805) 868-3523 1 [email protected]
EDUCATION
SAN LUIS OBISPO COLLEGE OF LAW, San Luis Obispo, CA
J.D. December 2020
M.L.S. December 2020
Honors: Top Student Award, Evidence
Activities: Student Representative, San Luis Obispo College of Law Student Bar Association CALIFORNIA STATE UNIVERSITY FRESNO, Fresno, CA
B.S., Criminology, May 2012
Activities: Fresno County Sheriff's Office Police Academy
EXPERIENCE
TWITCHELL & RICE, LLP, Santa Maria, CA Jun. 2021 - Present Attorney al Law
As an Attorney at Twitchell & Rice, LLP I practice civil litigation involving business entities, contracts, and real property. Also, practice Estate Planning including Wills, Trusts, and Probate.
Draft and file civil litigation complaints, motions, and written discovery.
DENMAT, Lompoc, CA Dec. 2016 - Nov. 2020
Accounts Receivable & Buyer
As an accounts receivable representative managed over 500 domestic customer accounts, prepared statements, invoices, and conducted data entry. As a buyer conducted inventory management and ordering of finished products, raw materials, and parts. Worked collaboratively with product managers and engineers on new product projects and launches. Daily management of purchase orders and contract negotiations with more than 300 vendors.
SAN LUIS OBISPO POLICE DEPARTMENT, San Luis Obispo, CA Oct. 2013 - Dec. 2015 Police Officer
As a patrol officer responded to calls for service throughout the city of San Luis Obispo.
Conducted criminal investigations involving persons and property crimes. Attended court for criminal cases, civil depositions, and traffic offense cases.
LANGUAGES & INTERESTS
Fluent in Spanish (reading, writing, and speaking).
Personal interests include gardening, hiking, and cycling.
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 21, 2022
Application Type: Block Grants Advisory Committee
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
CA -22-008
Hugo
Canton
1701 S. Thormburg St, 47, Santa Maria, CA, 93458
8058155032
[email protected]
5 REGISTERED VOTER: 1 Yes ❑ No
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: ❑2 Yes LI No
EDUCATIONAL
BACKGROUND:
OTHER RELEVANT
EXPERIENCE:
CIVIC OR COMMUNITY
INVOLVEMENT/GROUP
MEMBERSHIPS:
REFERENCES:
Name
Janet Silveria
E Yes No
High School + 2 years college
Communication Support Element US Army / Communications - Cryptography
Top Secret Clearance
Orange County, CA Juvenile Justice Commission
Address
Telephone
8057203084
Occupation
CEO Santa Maria
Community Bank
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
no
What is your understanding of this City Commission/Committee/Board? Assignment and distribution on Funds
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
no
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
N/A
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ID
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. understand that this document and all its attachments are available for public inspection upon request.
III IAGREE
Hugo Canton June 22, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: May 9, 2022
FIRST NAME: Nancy
LAST NAME: Crawford
CA -22-001
PRIMARY RESIDENCE: 4414 Countrywood Drive, Santa Maria , ca, 93455 PHONE: 8057171060
EMAIL ADDRESS: [email protected]
YEARS OF RESIDENCY: 5 REGISTERED VOTER: ❑O Yes 0 No
EMPLOYER: Care Connection Transport Services, CEO
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: 0 Yes ❑ No
EDUCATIONAL Nursing Certification at Allan Hancock; as well as other various BACKGROUND: certifications in healthcare, transportation, management, and mental health
OTHER RELEVANT
EXPERIENCE:
❑ Yes ❑v No
Older Adult Mental Health. Specialize in elderly disabled transportation. I work with local hospitals and non -profits throughout the Central Coast to meet Senior transportation needs.
CIVIC OR COMMUNITY Founded and run a local charity called Blessings in a Backpack. Member of INVOLVEMENT/GROUP the Santa Maria Women's Network. Investor Member of the Santa Maria MEMBERSHIPS: Chamber of Commerce
REFERENCES:
Name Address Telephone Occupation
Tuyet Nguyen [email protected] 805-598-0688 Svc Area Director for Care Coordination
and Social Work
Kenneth Dalebout [email protected] 949-246-1210 CEO at Arroyo Grande Community
Hospital
Mark Hall [email protected] 310-740-4372 Administrator at Lompoc Skilled
Nursing and
Rehabilitation Center
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes
What is your understanding of this City Commission/Committee/Board?
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
It is my understanding that the Board of Directors is responsible for the operations, including policy setting, allocations, and personnel for the Central Coast, such as Area Agency on Aging, HICAP, and Senior Information & Referral program. This Board serves Santa Barbara and San Luis Obispo Counties. The Board meets monthly.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
no
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
4414 Countrywood Drive, Santa Maria, CA 93455
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
Is there anything else you would like us to consider when reviewing your application?
1.I am applying fdr the Central Coast - Area Agency on Agirf op'eriing! I look forward to serving my community and looking after the welfare of our seniors.
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. 1 further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
M IAGREE
Nancy Crawford May 10, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 29, 2022
Application Type: Library Board of Trustees
CA -22-012
FIRST NAME: Charlie
LAST NAME: Baker -Boyd
PRIMARY RESIDENCE: 1972 Prell Road, Santa Maria, CA, 93454 PHONE: 916-802-5613
EMAIL ADDRESS: [email protected]
YEARS OF RESIDENCY: 4 months REGISTERED VOTER: 2 Yes ❑ No EMPLOYER: Santa Barbara County Assessor's Office
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED 0 Yes ❑O No OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: 2 Yes 0 No
EDUCATIONAL BA of Communication from the University of Southern California BACKGROUND:
OTHER RELEVANT Just completed term on the board.
EXPERIENCE:
REFERENCES:
Name Address Telephone
Dawn Jackson [email protected] 805-925-0994 x2319 Sara Lougee [email protected]
Laura Selken [email protected]
Occupation
Interim Library Director
Library Board Trustee
Library Board Trustee
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes, I am a member of the Board.
What is your understanding of this City Commission/Committee/Board? I have an intimate understanding of the Library Board of Trustees.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
Yes, I currently serve on the Library Board of Trustees.
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? No If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html)
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
Is there anything else you would like us to consider when reviewing your application? I enjoyed my first term on the board and look forward to continuing my service to the library.
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Charlie Baker -Boyd June 30, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 6, 2022
Application Type: Library Board of Trustees
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
CA -22-003
Helen
Galvan
702 E. El Camino Street, Santa Maria, CA, 93454
805-478-6230
[email protected]
44 REGISTERED VOTER: O Yes ❑ No
EMPLOYER: N/A
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE:
EDUCATIONAL
BACKGROUND: Masters, Education
Administrative Credential Certificate
OTHER RELEVANT Served on State and National Boards for the American GI Forum EXPERIENCE: Served on the SER-National Jobs for Progress Board CIVIC OR COMMUNITY American GI Forum
INVOLVEMENT/GROUP Santa Maria LULAC Council
MEMBERSHIPS: One Community Action
REFERENCES:
Name
Carmen Castro
Roy Bird
Maria Garcia -Cacique
Address
300 S. Las Flores Dr.,
Nipomo 93444
4340 Foxenwood Circle,
Santa Maria 93455
613 N. 7th St., Lompoc
93436
Telephone
805-860-6008
805-937-9437
805-740-1498
❑Yes❑O No
0 Yes 0 No
Occupation
Retired Teacher
Retired School District
Administrator
Teacher
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes, for the past four years
What is your understanding of this City Commission/Committee/Board? It is an advisory board on the everyday business of the library to assure equitable access to the services it provides.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
Library Board of Trustees, for 4 years.
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
702 E. El Camino St., SM 93454 - Residence
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
None
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
I AGREE I]x
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. 1 also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Helen Galvan June 7, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
Received on July 6th, after the July
1st Filing Deadline
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: July 5, 2022
Application Type: Library Board of Trustees
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
EMPLOYER:
CA -22-014
Randy
Jackson
612 S. Lucas Dr, Santa Maria, CA, 93454
8182824111
[email protected]
7 REGISTERED VOTER: 10 Yes ❑ No
(retired)
If yes, list the Department, Title and Date(s):
Assistant Library Technician 3/22-6/22
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE:
EDUCATIONAL BS - Applied Science
BACKGROUND:
OTHER RELEVANT
EXPERIENCE:
CIVIC OR COMMUNITY Pending (I just retired)
INVOLVEMENT/GROUP
MEMBERSHIPS:
Certified Safety & Health Official (Texas A&M)
❑ Yes 121 No
®Yes❑No
REFERENCES:
Name Address Telephone Occupation
Larry Maynard 11000 Phoenix Rd, 661-904-5253 Master Plumber (Retired) Apple Valley CA
Manuel Alvarado 661-755-5057 Contract Negotiator
(Retired)
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
No, But I have attended City Council & Planning Commission Meetings, and submitted comments and proposals
What is your understanding of this City Commission/Committee/Board? This Board oversees operations of the Santa including policies, rules, and procedures.
It also integrates a citizen's perspective into the management of the library.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
No, but I plan to do so
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
612 S Lucas Drive
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
None
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE 23
Is there anything else you would like us to consider when reviewing your application? I feel that I can apply a great deal of my military & federal agency experience to a position on the Library Board. My recent employment with the library provided me with a great deal of insight regarding how Library operations & management affects both employees and patrons.
When I was a child, my second home was the library and I have been a regular patron ever since.
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
® IAGREE
Randy Jackson July 5, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 21, 2022
Application Type: Library Board of Trustees
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
EMPLOYER:
Julie
Weaver
816 E. Orange St., Santa Maria, California, 93454
805-720-6330
[email protected]
Teacher, Santa Maria Bonita School District
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE:
EDUCATIONAL
BACKGROUND:
OTHER RELEVANT
EXPERIENCE:
REFERENCES:
Name
Martha Rodriguez
Lucia Carmona
Ann Moore
M.Ed, Curriculum and Instruction
Educator since 1993
Address
1415 Sonya Ln., SM
3296 Greenacre Dr., SM
4931 Pt. Sal Dunes Cir.,
Guad.
Telephone
805-714-9801
805-717-8594
805-598-1776
CA -22-009
❑ Yes ❑O No
▪ Yes 0 No
Occupation
Teacher, SMBD
Teacher, SMBSD
Parent
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
No
What is your understanding of this City Commission/Committee/Board? To provide input regarding Library Policy and to provide oversight of library to ensure they are fulfilling their mission and reaching their goals.
Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
No
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
816 E. Orange Street
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
n/a
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
Is there anything else you would like us to consider when reviewing your application? If the meeting time (1:00pm) is inflexible, this may prevent me from being eligible, as I work full time during school hours (7:30-2:45)
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, 1 will serve on the Commission/Committee/Board for which I have submitted this application. understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Julie A. Weaver June 22, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 29, 2022
Application Type: Library Board of Trustees
FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
YEARS OF RESIDENCY:
EMPLOYER:
Hunter
Jameson
1910 S. Wilma Way, Santa Maria, CA, 93458
(805) 346-1922
[email protected]
6 Retired
CA -22-013
REGISTERED VOTER: ❑✓ Yes ❑ No
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE:
EDUCATIONAL Ph.D., English, Indiana University, 1975
BACKGROUND:
OTHER RELEVANT Working with the written and printed word throughout my life as college EXPERIENCE: writing and literature teacher, newspaper reporter and editor, and writer for financial concern; volunteer tutor in reading and arithmetic for kindergarteners at Valley Christian Academy
Member and Church Council member of Santa Maria Foursquare Church
CIVIC OR COMMUNITY
INVOLVEMENT/GROUP
MEMBERSHIPS:
REFERENCES:
Name
Pastor Tim Mossholder
Liz Gutierrez
Lorraine Schneider
Address
1860 Melanie Ct., Santa
Maria 93454
615 Spyglass Drive
1292 Via Alta, Santa
Maria 93455
Telephone
(805) 888-1427
0 Yes ❑O No
M Yes 0 No
Occupation
Pastor
(805) 720-0298 Student advocate,
Laurus College
(805) 363-6054 Retired
GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
No
What is your understanding of this City Commission/Committee/Board? To advise the City Council and City Librarian on library matters Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
No.
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
SUPPLEMENTAL QUESTIONS:
Do you own real property in the City of Santa Maria? Yes If yes, please list the address(es):
Our family home at 1910 S. Wilma Way 93458
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
Santa Maria Foursquare Church, Church Council
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
❑x IAGREE
Hunter T. Jameson June 30, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
City of Santa Maria CA -22-010
APPLICATION FOR APPOINTMENT TO CITY COMMITTEES
Received Date: June 21, 2022 l
Application Type: Library Board of Trustees (coo UOPIAAj AAVI-5° FIRST NAME:
LAST NAME:
PRIMARY RESIDENCE:
PHONE:
EMAIL ADDRESS:
Betty
Gunn
3431 TURTLE CREEK DR, SANTA MARIA, California, 93455
8052601801
[email protected]
ARE YOU RELATED TO A CITY OF SANTA MARIA EMPLOYEE, ELECTED OFFICIAL, OR COMMISSION/COMMITTEE/BOARD MEMBER:
ARE YOU AT LEAST 18 YEARS OF AGE: v❑ Yes 0 No
EDUCATIONAL
BACKGROUND:
OTHER RELEVANT
EXPERIENCE:
CIVIC OR COMMUNITY
INVOLVEMENT/GROUP
MEMBERSHIPS:
0 Yes ❑O No
Applying for representative for Library Advisory Committee. Master's Degree in Education
Career teacher until retirement
Friends of the Orcutt Library
REFERENCES:
Name Address Telephone Occupation
Dawn Jackson 421 S McClelland 8059250994 Interium Librarian Carol Gregor Fallen Leaf 8059377820 Retired administrator Sheri Willebrandt Monaco Drive 8059342848 Retired math specialist GENERAL QUESTIONS:
Have you ever attended a meeting of the Commission/Committee/Board for to which you are applying? If so, how many?
Yes, every one
What is your understanding of this City Commission/Committee/Board? I would be continuing my participation on the Library Advisory Committee (LAC) Have you previously served, or do you currently serve, on a Santa Maria Commission or Committee? If yes, which one(s) and for what period of time?
Am on the Library Advisory Committee currently and in past years.
SUPPLEMENTAL QUESTIONS:
If yes, please list the address(es):
3431 Turtle Creek Drive
Please identify any organizations, associations, corporations, or entities by which you are employed or with which you are associated or do business with that might be affected by decisions of one or more of the Commissions/Committees/Boards, and the positions you hold in these entities.
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION
Friends of the Orcutt Library
If applying for, and are appointed to, the Appeals Board, Block Grants Advisory Committee, Library Board of Trustees, Planning Commission, Recreation and Parks Commission, or Measure U Citizens' Oversight Commission, you will be required to fill out a Form 700, Statement of Economic Interests, which identifies certain details of your financial interests beginning with the immediate 12 -month period prior to your appointment and annually on or before April 1 of each year thereafter. Please confirm that you have read Fair Political Practices Commission (FPPC) Form 700 Reference Pamphlet ( http://www/fppc.ca.gov/Form700.html) and the City's Conflict of Interest Code ( https://cityofsantamaria.civicweb.net/filepro/documents/24608) and you agree to file the required FPPC Form 700 Statements of Economic Interest, as required by the Political Reform Act and/or the City's Conflict of Interest Code. Once filed, the Form 700, Statement of Economic Interests, is a public document and available for inspection upon request.
IAGREE ❑x
Is there anything else you would like us to consider when reviewing your application? Would like to continue my participation on the Library Advisory Committee I agree that all of the information contained in my responses to the questions on this application are true and accurate to the best of my knowledge. I further agree that, by checking the box below and submitting this application, online or otherwise, I am affixing my digital signature to this form as of the date submitted. I also agree that if appointed, I will serve on the Commission/Committee/Board for which I have submitted this application. I understand that this document and all its attachments are available for public inspection upon request.
IAGREE
Betty Rose Gunn
June 22, 2022
THIS DOCUMENT AND ALL ATTACHMENTS ARE AVAILABLE FOR PUBLIC INSPECTION