APPLYING FOR (more than one may be checked)
Bicycle and
Pedestrian
Advisory
Committee
Colma Creek Flood
Zone Advisory
Committee*
Conference Center
Authority Business
Representative
Conference Center
Authority Community
Representative
Conference Center
Authority Hotel
Representative
Cultural Arts
Commission
Housing Authority Housing Authority
Tenant Commission
Library Board Measure W Citizens’
Oversight Committee
Parking Place
Commission
Parks & Recreation
Commission
Personnel Board Planning Commission San Mateo County
Mosquito And Vector
Control District*
SSF General Plan
2040 Community
Advisory Committee
Traffic Safety
Commission
Youth Commission
*County Boards and Commissions
Are you interested in participating in the Citizen’s Academy? Yes No
PERSONAL INFORMATION
___________________________________________________________ Name (last, first, middle)
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? ____ Have you attended any meetings of the commission/board for which you are applying? Yes No If yes, which one(s)?
BPAC
Are you a resident of South San Francisco? Yes _ No
If no, are you employed in South San Francisco? Yes _ No _ Number of hours employed in South San Francisco: ____
Housing Authority Tenant Commission
Are you a resident of the Housing Authority? Yes _ No _ Youth Commission – (Ages 14 to 22)
If not a resident of South San Francisco, are you a student of SSFUSD? Yes _ No _ Current school: _______________________________________ Conference Center Authority Hotel Representative
Which hotel within the City of South San Francisco are you representing?__________________________________________ The City of South San Francisco
Office of the City Clerk
400 Grand Avenue
South San Francisco, CA 94080
(650) 877-8518 (fax) (650) 829-6641
Application for Boards and Commissions
Carey, Christopher Michael South San Francisco, CA 94080 Traffic Safety Commission 36 I have viewed a Zoom meeting and usually read the minutes of meeting and agenda for n ✔ ✔
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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?
What qualifies you for this appointment?
What is your vision for growth in South San Francisco? ___________________________________________________________________ ________________________________________________________________________________________________________________ Are you currently receiving any form of compensation from the City for work performed? Yes _ No If yes, please explain:
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. ________________________________________________________________________________________________________________ Name and location of college/university/technical or trade school Degrees received ________________________________________________________________________________________________________________
________________________________________________________________________________________________________________ Name and location of college/university/technical or trade school Degrees received ________________________________________________________________________________________________________________
What community activities are you presently involved in, or have been in the past? _______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________ 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. ________________________________________________________________________________________________________________ Dates employed Employer Position
________________________________________________________________________________________________________________ Duties
________________________________________________________________________________________________________________ Dates employed Employer Position
________________________________________________________________________________________________________________ Duties
I have been a resident of South San Francisco for most of my life and want to contribute more to the city.
I am currently pursuing a degree in Urban Studies & Planning and have a My vision is a city that can still retain its working-class backgrou San Francisco State University, San Francisco CA. Bachelor's Degree in Urban Studies & Planning, estimated May 2022. Sacred Heart Cathedral Prep., San Francisco CA. Diploma earned May 2001. I have volunteered for ChangeSSF food distribution, as well as general upkeep around South San Franci ✔ ✔
I certify that, to the best of my knowledge, all statements in this application are complete and true. I agree and understand that any misstatement of material fact will cause me to forfeit all rights to appointment to a Commission, Board, or Committee with the City of South S
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).
PRINT AND MAIL TO:
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 Christopher (Chris) Carey
354 Catherine Drive
South San Francisco, CA
(650) 307-2002 (mobile)
[email protected]
OBJECTIVE: To obtain an internship and begin to gain experience in the planning field.
EXPERIENCE:
Capitol Glass Company San Francisco Bay Area, CA
Journeyman Glazier, Union Local 718 May 2016–Mar. 2021
• General Construction and Demolition, framing of window openings. • Installation of vinyl, metal, and wood-framed windows and skylights. • Cut, fabricate, and install glass and mirrors of different size, shape, and thickness. • Read and layout blueprints and floorplans. Operate heavy machinery and layout equipment when needed.
Additional Experience:
• Frosh/Soph Basketball Coach – Lick Wilmerding High School, San Francisco, CA. • Glazier/Installer – United California Glass and Door, San Francisco, CA. • Glazier/Installer - Dial Glass and Window Company, Pacifica, CA. • Grocery/General Merchandise Clerk – Lucky/Albertsons Supermarkets, San Francisco, CA • Guest Services/Usher – San Francisco Giants, San Francisco, CA • General Associate – Dudley Perkins Company, Harley-Davidson, South San Francisco, CA • Holiday Seasonal Retail
EDUCATION:
San Francisco State University San Francisco, CA
Pursuing Bachelor of Arts in Urban Studies/Planning ETA: May 2022 Skills: Microsoft Office, writing and editing of drafts, cash register and credit-card machine transactions, customer service, general labor and specialized construction skills, organization and time management, photography and editing skills(Photoshop, Lightroom, InDesign layout), social media networking.
REFERENCES: Available upon request, as well as contact numbers.