Boards and Commissions Application
Applicant Information
* Please accept my request to be reappointed to:
* Arts Commission
* Bicycle and Pedestrian Advisory Commission
* Board of Library Trustees (R)
* Heritage Preservation Commission (R)
* Housing and Human Services Commission
* Human Relations Commission
* Parks and Recreation Commission (R)
* Personnel Board (R)
* Planning Commission (R)
* Sustainability Commission
* First Name * Initial (optional) * Last Name
* Are you a Sunnyvale resident? Yes/No
[if yes] *How long have you lived in the City of Sunnyvale? Residence Notice:
Unless otherwise noted, your principal place of residence must be in Sunnyvale. You must live in Sunnyvale at the time of appointment and at all times during service on a board or commission. * Current Main Residence
* Email
* Phone
* Are you currently a registered voter in Sunnyvale? Yes/No [if yes] * When was the last time you voted? Month/Year * How long have you served on current your board/commission? * Have you ever served on another City of Sunnyvale board or commission? Yes/No [If yes] * Name(s) of boards or commissions previously served with approximate dates. * What new information about your qualifications would you like Council to know? * Reasons you wish to be reappointed?
* Any additional Information related to your reappointment?
Attachment 2
Demographic Information
Demographic information is voluntary. Your responses become public record. Your responses will help Council meet its goal of ensuring our boards and commissions reflect the demographic diversity of Sunnyvale residents.
* Your age:
* Under 18
* 18-24
* 25-34
* 35-44
* 45-54
* 55-64
* 65 and up
* Prefer not to answer
* Your gender:
* Female
* Male
* Non-binary/Non-conforming
* Transgender
* Prefer not to answer
* Other
[if Other] * Other:
LGBTQIA+ Identity (LGBTQIA+ stands for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, and the “+” is an all-inclusive way to include additional terms used to describe one’s gender, romantic, and sexual identities for those who do not identify with heterosexuality or the gender binary.) [description field]
* LGBTQIA+ Identity:
* Yes, I am part of the LGBTQIA+ community
* No, I am not part of the LGBTQIA+ community
* Prefer not to answer
* Race or Ethnicity (select all that apply):
* White
* Black/African American
* Asian
* Hispanic-Latin x/o/a/e
* Native American/Indigenous
* Native Hawaiian or Pacific Islander
* Prefer not to answer
* Other
[if Other] * Other:
Attachment 2
* Do you speak a language other than English? Yes/No
[if yes] * Which language(s)?
* Household Income
* Under $50,000
* $50,000 - $99,999
* $100,000 - $149,999
* $150,000 - $199,999
* $200,000 - $299,999
* $300,000 - $500,000
* Over $500,000
* Prefer not to answer
* Residence – are you a:
* Renter
* Homeowner
* Mobile homeowner
* Prefer not to answer
* Other
[if Other] * Other:
* Do you live in a:
* Apartment/Condo
* Single Family Home
* Mobile Home
* Prefer not to answer
* Other
[if Other] * Other:
* Do you have any other identities* you would like to share with us? *Such as veteran status, (dis)ability, national origin, religion.
Attachment 2
Your Agreement
IMPORTANT NOTICE – READ BEFORE SIGNING:
By selecting both “Yes” and “Submit Form” below I am adding my digital signature to this application. I am also agreeing with the following statements:
• All statements I have made on this application are true and correct. • I authorize the City of Sunnyvale (City) to investigate the accuracy of this information. • I release the City from all claims and liabilities arising from such investigation. • I acknowledge that any false statement on this application will be grounds for the City to deny my appointment. A false statement discovered later, will be grounds to dismiss me from my appointment at any time.
• I acknowledge that any false statement on this application could lead to criminal charges.
Charges could fall under California Penal Code, Section 115 or other applicable law. * Yes/No
* Y our full name
* Date
BACKEND WORKFLOW & NOTES –
Attachment 2