The City of South San Francisco
Office of the City Clerk RECD CITY GLERK
400 Grand Avenue 2022 MAR 11 A 9:08:22
South San Francisco, CA 94080
(650) 877-8518 (fax) (650) 829-6641
CALIFORNIA
Application for Boards and Commissions
APPLYING FOR (more than one may be checked)
Bicycle and Colma Creek Flood Conference Center Conference Center Pedestrian Zone Advisory Authority Business Authority Community Advisory Committee* Representative Representative
Committee
Conference Center Cultural Arts Housing Authority Housing Authority Authority Hotel Commission Tenant Commission
Representative
Library Board Measure W Citizens' arking Plac Parks & Recreation Oversight Committee Commissio Commission
Personnel Board Planning Commission San Mateo County SSF General Plan Mosquito And Vector 2040 Community
Control District* Advisory Committee
Traffic Safety Youth Commission
Commission
*County Boards and Commissions
Are you interested in participating in the Citizen's Academy? Yes No
PERSONAL INFORMATION
Camou. Francois, Arnaud
Name (lact firat middla)
South San Francisco, CA 94080
Address (number, street, and apartment number) City. State and Zip Code Telephone number Cell phone/alternative contact number E-mail address If you selected more than one Board/Commission/Committee of interest, please rank your preferences here, starting with your first choice.
How many years have you been a resident of South San Francisco? 24 Have you attended any meetings of the commission/board for which you are applying? Yes No D If yes, which one(s)? Conference Center
BPAC
Are you a resident of South San Francisco? Yes
If no, are you employed in South San Francisco? Yes No D Number of hours employed in South San Francisco:
Housing Authority Tenant Commission
Are you a resident of the Housing Authority? Yes No M
Youth Commission - (Ages 14 to 22)
If not a resident of South San Francisco, are you a student of SSFUSD? Yes No D Current school:
Conference Center Authority Hotel Representative
Which hotel within the City of South San Francisco are you representing? South San Francisco General Plan 2040 Community Advisory Committee What is your District of Residency?
Click here to locate your District.
Why do you want to be a member of a Board/Commission/Committee? What do you feel you could contribute? I am looking forward to continue to contribute my knowledge of event planning and want to see the conference center expand.
What qualifies you for this appointment? 26 years experience in business in SSF What is your vision for growth in South San Francisco? SSF is blossoming with new growth and construction.
My vision for growth is to make sure SSF is sustainable and provide employment for all as well as housing.
Are you currently receiving any form of compensation from the City for work performed? Yes No If yes, please explain: Conference Center Authority Board Do you have any relatives serving on Council, Commissions, Boards, and Committees or otherwise employed by the City of South San Francisco? Yes No If yes,
Name Position Relationship
EDUCATION - Please include additional information on separate sheet.
University of Nevada, Las Vegas MS
Name and location of college/university/technical or trade school Degrees received Las Vegas, Nevada
University of California, Riverside BA
Name and location of college/university/technical or trade school Degrees received Riverside, California
What community activities are you presently involved in, or have been in the past? SSF Conference Center Authority Board, Taste of South San Francisco, Higher Education for SSF, Men's Club of St. Veronica Parish, MISCELLANEOUS - Please include additional information on separate sheet or attach resume.
Military Service: Dates and branch
WORK EXPERIENCE - Please include additional information on separate sheet or attach resume. 03/01/1996 to present Basque Cultural Center General Manager Dates employed Employer Position
Duties
Dates employed Employer Position
Duties
I certify that, to the best of my knowledge, all statements in this application are complete and true. I agree and understand that any mis- statement of material fact will cause me to forfeit all rights to appointment to a Commission, Board, or Committee with the City of South San Francisco.
03-10-2022
Signature Date
The interest of the City is served best by actual and regular participation by Board and Commission members. Thus, upon the second absence from a regular meeting within any rolling twelve-month period, a member shall receive a written communication from the Mayor requesting that the member respond to the Mayor with an explanation for said absences within one week of the member's receipt of the written communication. The Mayor shall report to the City Council the reasons provided for the member's absences. If the City Council determines that the absences occurred for legitimate reasons, the City Council may excuse both or one of the absences. Members are also encouraged to give advanced notice of their absence from meetings.
Applications are accepted on a continuous basis and will remain valid 1 year from the date of submission. If you are selected to serve on a Board or Commission, you may be required to file an Annual Statement of Economic Interest (FPPC Form 700) and bi-annual Ethics Training (AB1234).
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CITY OF SOUTH SAN FRANCISCO
Office of the City Clerk
400 Grand Avenue, South San Francisco, CA 94080
For more information, call (650) 877-8518
For official use only Accepted Not Accepted Initials Date