Submit Date: Jan 25, 2023
Email Address
First Name Last Name
Street Address
City State Postal Code
Primary Phone Alternate Phone
Employer Job Title
Application for appointment and background information for City of Stockton Boards, Commissions, and Committees
Profile
Ethnicity
Gender
What district do you live in? *
District 4
I declare under penalty of disqualification/termination that I have been a resident at the above address for years/months?
9 years
The City of Stockton uses email as the preferred method of communication regarding your application. Is this acceptable to you?
Yes No
Employer Address
Jamie Guerrero
Stockton CA
Jamie Guerrero
Attachment D
Are you currently serving on a City of Stockton Board, Commission, or Committee? Yes No
Which Boards would you like to apply for?
Water Advisory Group: Submitted
Question applies to multiple boards
NOTE: This Board requires membership with one of the following groups. If none, please remove board from your application. Are you knowledgeable, have experience in, or extensive background in any of the following areas? Select all that apply. * Active in community activities significant enough to confirm knowledge of issues and individuals within the community
I have been a resident of Stockton for at least 3 years.
Yes No
Question applies to Water Advisory Group
Do you reside within one of the Stockton Municipal Utilities' three utility service areas? Yes No
Question applies to Water Advisory Group
If yes, state which one:
California
Interests & Experiences
Please tell us about yourself and why you want to serve.
Interested in my community and how it works.
Please state the reason you would like to be a member of this board/commission.
Would like to represent the community and learn about the water systems delivered.
Jamie Guerrero
Attachment D
Upload a Resume
Have you served on an advisory group before?
Yes No
How did you hear about the position?
Post on Instagram
City Council Policy 100-2 states that Commissioners are required to attend meetings on a regular basis. If appointed, will you be able to attend meetings regularly and devote the time necessary to fulfill your duties as a member?
Yes No
Do you or immediate family members have any relationship (professional, financial, other) that may present a potential conflict of interest for this advisory group? Yes No
Background Information
Based on your best judgment, does this Commission make decisions that may affect any sources of income, interests in real property, or investments of you or your spouse? Yes No
Voter Registration (Questions appear if required)
Submit Application
Enter Your Initials:
Jg
Date Signed
01/22/2023
Jamie Guerrero
Attachment D