COUTH SAN TRA 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
CALIFORNI
Application for Boards and Commissions
APPLYING FOR (more than one may be checked)
Bicycle and Conference Center Conference Center Conference Center Pedestrian Advisory Authority Business Authority Community Authority Hotel Committee (BPAC) Representative Representative Representative Housing Housing Authority
Cultural Arts Equity and Public
Commission Safety Commission Authority Tenant Commission Library Measure W Citizens* Parking Place Parks & Recreation Board Oversight Committee Commission Commission
SSF General Plan 2040
Personnel Planning Traffic Safety
Board Commission Community Advisory Commission
Committee
Youth
Commission
Are you interested in participating in the Citizen's Academy? Yes
PERSONAL INFORMATION
Maharaj, Zubin Thomas
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.
Youth Commission then Equity and Public Safety
How many years have you been a resident of South San Francisco? 12 Have you attended any meetings of the commission/board for which you are applying? Yes No If yes, which one(s)? Youth Commissions
BPAC
Are you a resident of South San Francisco? Yes
If no, are you employed in South San Francisco?
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 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? Right now, I am on the Cultura Art Commission. I have contributed a lot and feel I could be even more effective on another committee.
What qualifies you for this appointment?! am a SSF Resident with strong commission experience presently.
What is your vision for growth in South San Francisco? / have been succeesful at raising my family here in SSF. I have tremendous pride in my city and want future citizens to have the same success I have had.
Are you currently receiving any form of compensation from the City for work performed? Yes No I am paid for being on the Cultural Art Commission
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 Reena Maharaj Conference Center Board Wife
Francisco? Yes If yes,
Name Position Relationship
EDUCATION - Please include additional information on separate sheet.
University of Phoenix MBA
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? Currently on Cultural Arts Commission. Been serving in national and domestic elections for over 20 years.
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.
May 2019 - present Proterra Human Resources
Dates employed Employer Position
Human Resources and Talent Acquistion needs
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 Cormittee with the City of South San Francisco.
9-13-22
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 respood 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 deternines that the absences occured 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 offrcial use only Accepted Not Accepted Initials FA Date X 09/1 L3/2022