Submit Date: Aug 11, 2025
Email Address
First Name Middle
Initial
Last Name
Street Address
City State Postal Code
Primary Phone Alternate Phone
Employer Job Title Occupation
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
The City of Stockton uses email as the preferred method of communication regarding your application. Is this acceptable to you?
Yes No
Employer Address
Are you currently serving on a City of Stockton Board, Commission, or Committee?
Yes No
Susan H Lenz
Stockton CA
Susan H Lenz
ATTACHMENT A
Which Boards would you like to apply for?
Measure A Citizens' Advisory Committee: 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
Possess decision-making abilities
Understanding of Ethnic/Gender Diversity
Understanding of the Stockton Public Art Plan processes and implications for the City of Stockton
Willingness to tolerate/promote change
Interests & Experiences
Please tell us about yourself and why you want to serve.
I am a lifelong Stockton resident and am very interested in continuing to serve my community.
Please state the reason you would like to be a member of this board/commission.
I understand Measure A very well after serving on the City Council for 8 years. I and am very interested in continuing to serve my City.
Have you served on an advisory group before?
Yes No
How did you hear about the position?
I heard about this from a councilmember who advised me of the vacancy.
Susan H Lenz
ATTACHMENT A
City Council Policy 3.03 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
Please identify any specialized accommodations needed for equal participation:
N/A
Enter Your Initials:
SHL
Date Signed
August 11, 2025
Susan H Lenz
ATTACHMENT A