RECEIVED
By Sandra at 3:45 pm, May 23, 2023
CITY OF VERNON
COMMISSION AND COMMITTEE
APPLICATION
Commission/Committee (see page 2 for qualifications):
lJusiness and lndustry Commissron as a:
O Business Representative Qneaf Estate Professional CUoor. Representative lCommUNlTY Fund Grant Committee as a:
Q ausiness Representative Qr"rnon Area Representative
Cemptoyee of Vernon Business OResioent
@environmental Representative QlaOor Representative
l_luousing Commission as a:
CBrsiness Representative
Green Vernon Commission as a:
Qausiness Representative
Name: Alfred Mejia
Residence Address:
Occupation: EHS Coordinator Emproyer: Barksdale lnc
EmproyerAddress: 3211 Fruitland Ave Vernon, CA 90058
Email:
Qualifications and Reasons for lnterest in Serving on a Commission / Committee (attach additional sheet if necessary):
EHS employee looking to help company move forward in safety initiatives.
By signing below, I affirm that I meet the requirements of the appointing category I have indicated.
Signature: Alfred Mejia Date: 0512312023
Email to [email protected] or Mail to City Clerk Department, 4305 Santa Fe Avenue, Vernon, CA 90058.
Q u al if ic ati on s confi rmed by
.(Business EReal Estate lLabor fl Environmental E Vernon Area [f Employee nResident lE4c fusiv e $ I n[us trin t