Item 05 - Citizen Service Appointments to Various Commissions and Committees

Agenda Item No. 5

CITY OF YUCAIPA

AGENDA REPORT
TO: Honorable Mayor and City Council
FROM: Jennifer Crawford, Assistant City Manager/City Clerka(L Kimberly Everts, Deputy Rent Administrator/Records Technician FOR: City Council Meeting of December 12, 2022
SUBJECT: Citizen Service Appointments to Various Commissions and Committees RECOMMENDATION:

That Councilmembers Beaver, Duncan, Garner, Thorp and Venable each appoint one member to the Healthy Yucaipa Committee, and that the City Council appoint two at -large members to the Healthy Yucaipa Committee; and

2. That Councilmembers Beaver, Duncan, Garner, Thorp and Venable each appoint one member to the Mobilehome Rent Review Commission; and

3. That Councilmembers Beaver, Duncan, Garner, Thorp and Venable each appoint one member to the Parks and Recreation Commission; and

4. That Councilmembers Beaver, Duncan, Garner, Thorp and Venable each recommend and nominate one member for appointment to the Planning Commission, and that the City Council appoint two at -large members to the Planning Commission; and

5. That City Council appoint five at -large members to the Public Arts Committee; and

6. That Councilmembers Beaver, Duncan, Garner, Thorp and Venable each appoint one member to the Trails and Open Space Committee, and that the City Council appoint four at -large members to the Trails and Open Space Committee; and

7. That City Council appoint three at -large members to the Vector Control Committee; and Based on Council direction pertaining to the 2023 Membership on Council Committees, Regional Organizations and Ad -Hoc Committees (in a separate staff report included in the Agenda Packet), if appropriate, direct staff to conduct recruitment for the current vacancies on the Comprehensive Economic Development Strategy Committee and the Economic Development Advisory Committee; and

9. Based on Council direction pertaining to the 2023 Membership on Council Committees, Regional Organizations and Ad -Hoc Committees (in a separate staff report included in the Agenda Packet), if appropriate, appoint three at -large members to the Yucaipa Valley Wine -30-

Country Planning Committee (formerly American Viticultural Area Planning Committee); and

10. That City Council provide direction on whether the Citizen Service Applications received, that do not meet the qualifications of membership, should be:
a. Exempt from the language of Section 5.1 of Resolution No. 2014-81. b. Accepted with an amendment to the language of Section 5.1 of Resolution No. 2014- 81 to recognize U.S. Postal Service Yucaipa addresses that are located outside of city boundaries.
c. Denied.

DISCUSSION:

Pursuant to Resolution No. 2014-81, each commission or committee member's term (at -large and individual Councilmember appointments) shall run consistent with the general municipal election and shall be for two -years from January 1 to January 1. On January 1, 2023, the term of City Council appointments to the Healthy Yucaipa Committee, Mobilehome Rent Review Commission, Parks and Recreation Commission, Planning Commission, Public Arts Committee, Trails and Open Space Committee, Vector Control Committee, and Yucaipa Valley Wine Country Planning Committee will expire.

Staff conducted recruitment for the upcoming vacant positions by notifying current commission/committee members of their term expiration dates, publishing ads in the local newspaper, posting notices at City Hall and at the Yucaipa Branch Library and by reaching out to the community through the City's website and social media outlets. In response, several Citizen Service Applications were received by the General Services/City Clerk Department by the November 2 1 " 5 p.m. deadline; however, nine additional applications were received after the deadline and are identified with an asterisk (*) by their names on Exhibit A (List of Citizen Service Applications Received), attached hereto.

Additionally, applications were received that include U.S. Postal Service recognized Yucaipa addresses listed as a primary residence but are located outside of city boundaries. These addresses were likely issued by the County of San Bernardino for the Yucaipa area prior to the City's incorporation and establishment of the actual city boundary. This issue was first discovered in 2021 after Council appointments were finalized. In order to identify whether applicants are in conformance with Section 5.1 of Resolution No. 2014-81, which states that commission or committee members shall either be residents, property owners or business owners of the City of Yucaipa, staff maps each application to verify residency. If residency is not qualified, a phone call is made to the applicant to obtain additional information that might satisfy the membership requirements pursuant to Section 5.1 of Resolution No. 2014-81. The City has received three Citizen Service Applications that do not meet the membership requirements. Staff has mapped these addresses (Exhibit B) to provide Council a visual representation of the point in question and seeks direction in determining whether the applications received qualify for membership on a Council commission or committee. Exhibit A identifies these applicants with bold type.
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Each applicant has been notified of this meeting and advised that Council desires their attendance in order to provide additional information, if needed.

Staff recommends that Council appoint members to the Healthy Yucaipa Committee, the Mobilehome Rent Review Commission, Parks and Recreation Commission, Planning Commission, the Public Arts Committee, Trails and Open Space Committee, Vector Control Committee, and provide direction to staff in regard to other committees. Staff also recommends that Council consider whether applications received that do not meet the qualifications of membership as stated in Resolution No. 2014-81 should be exempt or if the language of Section 5.1 should be amended to recognize U.S. Postal Service Yucaipa addresses that are located outside of city boundaries.

Attachments: Exhibit "A" — List of Citizen Service Applications Received and Citizen Service Applications redacted
Exhibit " B" — Boundary map and applicant address locations Exhibit C — Portion of Resolution No. 2014-81 (Section 5.1) Approved by
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Exhibit "A"

LIST OF CITIZEN SERVICE APPLICATIONS RECEIVED
Healthy Yucaipa Committee, Mobilehome Rent Review Commission, Parks and Recreation Commission, Planning Commission, Public Arts Committee, Trails and Open Space Committee, Vector Control Committee, and Yucaipa Valley Wine Country Planning Committee.

Asterisk * — represents applications received after deadline of 11/21/2022 5 p.m. (late submission).

Bold type — represents applicants who do not meet the qualifications of membership (Resolution No. 2014-81) that states commission or committee members shall either be residents, property owners or business owners of the City of Yucaipa.

Healthy Yucaipa Committee (7 Vacant Positions)
Jeff Distelberg
Meredith Sherwin
Cynthia Lopez -Winter* Heather O'Bier*
Mobilehome Rent Review Commission (5 Vacant Positions)
William Reagan
Parks and Recreation Commission (5 Vacant Positions)
Denise Allen
Darren Espiritu
Erik Sahakian
Tim Carlisle
Maureen Ingalls
Douglas Witham
Planning Commission (7 Vacant Positions)
J.R. Allgower
Shawn Burdine
Brian Lowell
Dennis Miller*
Lloyd Rekstad
Donna Snodgrass
Colleen Wang
Richard Beck
Tony Hicks*
Christopher Markarian
Kristine Mohler
Cesar Roldan
Ian Tillen
Hansen Wang
Public Arts Committee (5 Vacant Positions)
Daryl Bryan
Lillian Vasquez
Bethanne Keirnan
Trails and Open Space Committee (9 Vacant Positions)
Kathryn Barton
Kellie LaRocco*
Kristine Mohler
Ian Tillen
Kris Woolard
Kandie Cansler
Leonard LaRocco*
Robert Richmond
Adam Tissot
Cathy Coate
Leonard LaRocco*
Bart Brizzee
David Higginson
Steve Mierzwik
William Reagan
Meredith Sherwin
Lyle Vick
Kit Satre
DeDe Chudy
Douglas Leach
Patrick Smith
Kathy Utley
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Vector Control Committee (3 Vacant Positions)
Kellie LaRocco*
Mike McCuistion*
Yucaipa Valley Wine Country Planning Committee (3 Vacant Positions) James Matlock
Colleen Wang
Kristine Mohler
Cesar Roldan
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Exhibit "B"
Citizen Service Applicants Located Outside of Yucaipa City Limits 0 Citizen Service Applicants Outside of Yucaipa City limits Cathy Coate
im Carlitlo�
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Exhibit C

5.1 MEMBERSHIP
Commission or Committee members shall either be residents, property owners or business owners of the City of Yucaipa, California.

5.2 MEETING ATTENDANCE
City Council appointees to commissions and committees fulfill a vitally important role in governing the City, and are held in high regard. Therefore, barring unusual and emergency circumstances, an appointed advisory member is expected to attend and participate in all of the meetings held by the body to which the member is appointed.

5.3 REMOVAL, RESIGNATION, AND VACANCIES
A. Removal
Unless otherwise authorized by the City Council due to special circumstances, a commission or committee member's term shall be automatically terminated, with or without cause, upon one or more of the following:

1. The member is absent from three consecutive meetings of the body, regardless of the type of meeting (regular, special, adjourned, etc.) in a 12 month period if they meet monthly; or

2. The member has missed 25% of the meetings of the body, regardless of the type of meeting (regular, special, adjourned, etc.) in any 12 month period.

3. A motion is adopted by the affirmative votes of no less than three Council members declaring the member's term to be terminated.

B. Resignation
Any member of a commission or committee may resign upon notification, in writing to the City Council, commission or committee chairperson, and staff liaison.

C. Vacancies
Vacancies shall be filled in the same manner as initial appointments and shall be for the remainder of the unexpired term.

SECTION 6. TERM
Each commission or committee member's term (at -large and individual Councilmember appointments) shall run consistent with the general municipal election and shall be for two -years from January I to January 1.

Student commission or committee members shall serve a single ten month term, from September through June.
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HEALTHY YUCAIPA

COMMITTEE
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DocuSign Envelope ID: 06D9AAE2-EDC9-4C38-8450-77A18246B5E9 4` CITY OF YUCAIPA ReceiVWED
"lit
Ci yflatt:Yucaiga `,' 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
General Services/
CITIZEN SERVICE AI'PLICA� t• OI'rT<'F Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Jeff D. Distelberg
First Middle Last
-■-Yucnipa CA (92399
Address:

Number and Street City "Lip Code
Home Work Cell Phone:

Phone: NSA Phone:

Ismail:

Occupation: Healthcare Administration
Masters Degree - Marriage and Family Therapy ; Bachelors - Business Educational Background:

Cominission or Committee for which you are applying: Healthy Yucaipa If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

DocuS(pned by:

Applicant signature: .� %• �1Sf t (1°U^
Why are you interested in this position?
I have served on this committee for the last two years and it has been quite fulfilling.

In spite of the challenges COVID brought to our community, we successfully brought back the first annual health fair for the city.

Additionally, we completed a Healthy Yucaipa drive thru testing kit give away during the Delta surge.

Our committee has three additional health events planned between Thanksgiving and Easter, 2023.

Recommended for a second term by Justin Beaver, Yucaipa City Council Mayor Pro Tern

ATTACH A RESUME AND/OR ADDITIONAL (INFORMATION WHICH YOU FEEL WILL, ASSIST THE CITY COUNCIL IN TI•LEIR SELECTION.

DocuSign Envelope ID: 06D9AAE2-EDC9-4C38-8450-77A18246B5E9

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this conuni ss ion/committee?
1, Extensive work experience in the area of wellness events for large audiences

2. Extensive experience in the area of healthcare and wellness 3, Strong relational skills - collaborative, creative, team player, communication skills How long have you resided in Yucaipa? since 2008
REFERENCES:

1. Justin Beaver - Yucaipa City Council, Mayor Pro Tem (recommending me for the second term)

2. Greg Bogh - Yucaipa City Council Member
Applicants are advised that they may be requested to .make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Do US' nod by:

Signature of Applicant: �• �iS>Zt �I't VI� Date: 10/27/2022 Z:1GENrRAL SERVICES - CITY CLERK',COUNCIL, COMMISSIONS, COMMITTEESTitizcn Scrvicc Application.doc -39-

Jeff Distelberg, LMFT
Professional Goal Statement:

I am privileged to work for Kaiser Permanente, a leading health care organization.

Currently, I serve in the role of Assistant Medical Group Administrator for the San Bernardino County Senricc Area. With my training and experience, I aspire to serve our community by elevating the level of health in the Inland Empire.

Profile:

Assistant Medical Group Administrator, SCPMG. September 2015- Present Responsibilities: Oversight of multiple outpatient departments with a budget of over $175M. I am the lead administrator for special projects supporting various medical group operations, ambulatory quality metrics, people and culture strategy, and wellness.

Director of Behavioral Health Care Services, SCPMG 2013-2015 Responsibilities: I partnered with two physician chiefs of service in Mental Health and Addiction Medicine. I have oversight of clinical operations related to outpatient care clinics, strategy, inpatient operations, capital planning, and outside provider contracts.

Department Administrator, Montclair Mental Health, SCPMG 2009-2013 Responsibilities: Oversight of clinical operations, patient care experience and facilities.

Additionally, I coordinated care with other administrators across the service area.

Psychiatric Social Worker — San Bernardino County Service Area, SCPMG 2001-2009 Responsibilities: Direct patient care to health plan members. Provided individual, family and group counseling services. Served on various departmental committees working to support operations and enhance patient care.

Education & License:

LMFT — Licensed Marriage and Family Therapist, since 2001.

M.S. — Marriage and Family Therapy, Loma Linda University B.A. — Business, Calvin College
Relevant Experience.

Advanced Management Program, collaborative between KP and USC — Dec. 2016 Middle Management Program, Kaiser Permanente — Fall 2014 Healthy Yucaipa Committee (reports to the City Council) January 2021 — Present Yucaipa Youth Basketball Coach 2012 - 2017
M

Received
CITY OF YUCAIPA t cCEIVED
lift
34272 YUCAIPA BOULEVARD Date:DEC 012022
YUCAIPA, CA 92399en mC�-, /
(909) 797-2489 C ty Clor1L.'

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Cynthia "Cindy" Lopez -Winter
First Middle Last
Address: Yucaipa 92399
Number and Street City Zip Code
Florae
Phone:

Work
Phone:

Cell Phone:

Email:

Occupation: L&D Consultant�HR)
Educational Background: B.S Pre Physical Therapy & Psychology Minor Commission or Committee for which you are
applying: Healthy Yucaipa Committee
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I had a scholarship to run cross country and track in college. My husband and I strive to have our children lead a healthy lifestyle. Not only do I envision a long, prosperous, and healthy life in our beloved Yucaipa, but I dream of the opportunity to help make our city safe and healthy.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
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CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
I. Education background in a health science.

2. Leadership exerience as a cross country coach for 7 years.

3. Passion to influence others to lead a healthy and active lifestyle.

How long have you resided in Yucaipa? 1.5 years.

REFERENCES:

1. Wiiliam Winter -

2. Liz Lopez -
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant:

Date: 12/01 /2022
hops:/(yucaipa.sharepoint.com/sites/GcrcralScrvices/Shared Documents/Gencral Services —City Clerk /(1? CITY CLERK FILESICOUNCIL, COMMISSIONS, COMMITTEESrCitinn Service Application.doc
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Received
r
CITY OF YUCAIPA city �; • VED sj
1 1' 34272 YUCAIPA BOULEVARD NO2022
YUCAIPA, CA 92399 By- 4k
(909) 797-2489 Geller I Servidew
City Cler

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters �et� for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Heather L. O'Bier
First Middle l..ast
Address: _ Yucaipa 92399
Number and Street city Zip
_------_.-_—.-
y Zip Code
Home 'Work Cell Phone: —
Phone: Phone:

Email: ■
Occupation: DNP/RN- District Nurse for Yucaipa Calimesa Unified School District Educational Background: Doctorate of Nursing Practice
Commission or Committee for which you are
applying: Healthy Yucaipa
If you are applying to the Mobilchome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilchomc park in the City of Yucaipa, that. I have no financial interest (as defined by state law) in any mobilchomc or mobilehome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
As a health professional, I understand the importance of a healthy lifestyle and I want to share my knowlege and experience on a committee where it can benefit the citizens of Yucaipa.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
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CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/comtnittec?
L My nursing education and 23 years of nursing experience in community health

2. My personal and professional knowledge on health and fitness

3. My community involvement, including being a current member of Healthy Yucaipa committee
How long have you resided in Yucaipa? 1 1 /2 years
REFERI;NCES:
1, Cali Binks- Superintendent Yucaipa Calimesa Joint Unified School District

2. Megan Wolfe -Director of Community Services, Yucaipa Applicants arc advised that they may be requested to make inforination available regarding any potential conflict of interest: arising irony their businesk/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be rctunied to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92')99, prior to any closing dates established.

I CERTIFY TIIAT TIE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: `'_ : _j t' ( ';, 4 `� �i `. Date:
hops;rfyueaipa.sharcpoiut.conJsitc.fGeneralScrvice,/5ltared Docwnents!0encral Services_City Clerk ({a CITY CtAtK FILFS,COUNCIL., COMMISSIONS, CONAM[TTEESlCitiacn Scrvicc Applicadon.doc in

Heather L. O'Bier
Academic Education:
2014 to 2017: Grand Canyon University, Doctorate of Nursing Practice 2005 to 2009: California State University Fullerton, MSN/School Nursing Concentration 2003 to 2005: California State University Dominguez Hills, BSN 1997 to 1999: Victor Valley College, Associate Degree Nursing Certifications and Training:

Clear School Nurse Services Credential
School Audiornetrist Certificate # S-8627
Public Health Nurse Certificate
Special Teaching Authorization in Health (STAH)
Basic Cardiac Life Support (BCLS)
Professional Experience:
2021 to Yucaipa Calimesa Unified School District
Present 12797 Third Avc Yucaipa, Ca. 92399
District Nurse
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Duties: To provide comprehensive health services to students' grades K-12, including those with special needs. Perform specialized procedures such &,; tracheostomy care, catltcterizations, and g-tubc feedings. To supervise and train health technicians. Clinical supervisor for on -site immunization program. Complete mandated hearing and vision screenings. Assist with the development and planning of health education programs.

Develop individualized health care plans. Medi-Cal billing for eligible students. 2017 to California State University Fullerton
Present 800 N State College Blvd. Fullerton, Ca. 92831
Part- Time faculty, School of Nursing
Duties; To provide and coordinate teaching activities in the online learning environment at the undergraduate and graduate nursing level. Preparation of syllabus and teaching of curriculum according to the goals and objectives of the department. Participation in faculty meetings and departmental activities as identified by the department chair or program director. Support graduate -level education in public health practice. Develop, deliver and assess graduate -level curriculum in the areas of quantitative research skills.

Utilize virtual simulation programs for the undergraduate student. 2016 to Lewis Center for Educational ltescarclx
2021 17500 Mana Rd Apple Valley, Ca. 92307
District Nurse
Duties; to provide direct care to ill or injured K-12 students, and staff. Conduct mandated vision and hearing screenings, provide referrals, and compete state reports. Comply with student immunization requirements per local, state, federal and district guidelines.

Educate staff and parents regarding communicable disease, reporting as necessary.

Develop and maintain communication with community health resources. Assist in the development and teaching of prc-nursing or other health related courses. Promote health policies and procedures. Participant on Wellness committee. Participant on Health and Safety Committee including Covid back to school planning and contact tracing. Advisor for High Desert Medical Explorer Post 117447. Advisor for hlealth Occupation Students of America (HOSA).
2010 to Azusa Pacific University
2017 901 East Alosta Ave. Azusa, Ca, 91702
Adjunct Faculty, School of Nursing
Duties; to provide and coordinate teaching activities in the online learning environment including student assignments, clinical supervision, and evaluation of students at the undergraduate level. Preparation of syllabus and teaching of curriculum according to the goals and objectives of the department. Participation in faculty meetings and departmental activities as identified by the department chair or program director.

2005 to Hesperia Unified School District
2016 15576 Main St. Hesperia, California 92345
District Nurse
To provide comprehensive health services to students' grades K-12, including those with special needs. Perform specialized procedures such as tracheostomy care, catheterizations, and g-tube feedings. To supervise and train health technicians. Clinical supervisor for on -site immunization program. Complete mandated hearing and vision screenings. Assist with the development and planning of health education programs.

Develop individualized health care plans. Medi-Cal billing for eligible students.

Participant on School Attendance Review Board (SARB). Member of various community agency committees.
2000 to St. Mary Medical Center
2005 18300 Highway 18 Apple Valley, California 92307
Registered Nurse: Healthy Beginnings- Mammy & Me
To provide care to prenatal, antepartunt and postpartum patients. Perform infant assessments. Provide lactation education and support to prenatal, and postpartum patients. Teach breastfeeding and birthing classes to prenatal patients.

Registered Nurse: NICU
Duties; to work independently in a Level 11 Neonatal Intensive Care Unit. Attend/assist in the resuscitation of the high -risk neonate in the delivery room. Provide a supportive and educational environment to the childbearing family, including the adolescent mother.

Maintain knowledge of current breastfeeding techniques/assisting the postpartum mother with those techniques. Preceptor to new staff.
1999 to Loma Linda University Medical Center, Children's hospital 2000 11234 Anderson Avenuc Loma Linda, California 92354 Registered Nurse: NICU
Duties; to work independently, and as a team member in a 72 bed Level III Neonatal Intensive Care Unit. Care for critically ill infants while developing short and long term care plans for the patients and their families. Discharge planning; infant CPR, medication administration, and infant safety measures.
1995 to St. Mary Medical Center
1999 18300 Highway 18 Apple Valley, California 92307
Monitor Technician / Certified Nursing Assistant
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Duties; to interpret and document cardiac rhythms utilizing multiple telemetry monitoring systems. To be a paint of contact for physicians, other hospital staff, and family members.

Preceptor to new staff. Unit Base Committee Representative, Certified Nursing Assistant
Duties; to directly interact and care for patients and their families providing; bathing, feeding, and all daily living activity assistance.

Promoted to above position.

Licensure: California Registered Nurse #556390
:'awards: Boy Scouts of America, Inland Empire Council- High Desert District - Explorer Advisor of the Year 2019
Lewis Center for Educational Research, Academy for Academic Excellence, Employee of the Semester — Fall 201.8
Lewis Center for Educational Research, Academy for Academic Excellence, Employee of the Semester— Spring 2017
Hesperia Unified School District Employee of the Year- Administration and Education Support Center- 2014
Professional National Association of School Nurses (NASN) Affiliations: California School Nurses Organization (CSNO) San Bernardino County School Nurse and Physician Collaborative Member
Sigma Theta Tau International, Honor Society of Nursing

Scholarly work/ Presentations:

February 2019
California School Nurse Organization (CSNO) 69th Annual Conference: Building a Healthy Community: One Family at a Time- Presentation- Protocol/Tools for Supervision of the LVN in the School Setting
February 2020
California School Nurse Organization (CSNO) 70th Annual Conference:

Presentation -The Good, The Bad, and the Ugly about BRN Complaints- What You Need to Know
Community: Committee member, I-Icalthy Yucaipa,City of Yucaipa (2022- Present) Yoga/Yoga Trapeze instructor- Revolution Fitficss (2022- Present) Stop the Bleed, Instructor (2018 — Present)
Advisor, Health Occupation Students of America (IIOSA), Future Health Professionals, Academy for Academic Excellence (2017 -- 2021) Advisor, High Desert Medical Explorer Program (2016 — 2021) Coach, Students Run LA, Academy for Academic Excellence (2016- 2020)
Camp Nurse, Calvary Chapel High Desert (2012 — 2017)
Volunteer, School Nurse Consultant, Hesperia Christian School (2005 — 2016)
Parent Volunteer, Hesperia Christian School (2005 — 2016) School Attendance Review Board Member, Hesperia Unified School District (2005-2016)
.•

Additional information for Heather O'Bier citizen service application:

I have been a part of the Healthy Yucaipa Committee since 2022. 1 actually sought out the opportunity because I wanted to get involved in my new community I now call home.

One of the things I wanted to see happen for our community was community runs. Upon making a suggestion to the committee, we moved forward and are holding our first run as part of a holiday run series that was approved with the support of city council on Thanksgiving day.

I also have a passion for kids health and fitness. I have been a participant of the Yucaipa Trails and Open Space monthly hiking events and have been asked to be a part of new program they are trying to start for children called Young Detectives to get more kids involved in the monthly hikes. I will be attending the California Trail and Greenway conference in March to learn more about the Young Detective program.

Lastly, as a nurse, I have worked with nurses who suffer from burnout and have learned the importance of self -care. I started doing yoga as part of my self care, and I now teach yoga and yoga trapeze at one of our local gyms (Revolution Fitness0 where I am a member.

Thank you for your time and consideration for a member position on the Healthy Yucaipa Committee.
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Deceived
CITY OF YUCAIPA City Lq ' LD
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 By.
(909) 797-2489 General Serv(dAjW'
City Clerk',,

Name of Applicant: ;� jF•i?'.l�ll:�
Address:

Number and Street
Home
Phone:

Email:
le Last
ity Zip Code
Occupation: �
&,W Cf y
Educational Background:

Commission or Committee for which you are applying: 6 f �LC- , ezu ar J eC,J If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest. ,,
Applicant signature: 1��t'.C�C6 ,WVU0 ltz'"�
Why are you interested in this position?
141 Cewyl rp tk • isl e-
ATTACH A-/RE1WME AN1WR ADDITI AL INK
ASSIST THE CITY COUNCIL IN THEIR SELECTION.
om-n I / •)Y 7rl--t
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4D
/LAmb
Lt /0 C'/J,

ATION WHICH YOU PEEL WILL
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CITIZEN SERVICE APPLICATION

PAGE TWO
WI1,1t do you Consider to hC three (3) major assets that. would qualify you for selection to this commission/committee?

1. �,� G�DZ�C,C cLl LFZ /� 6L-U C� �j�rt, 30 ! . �. a,I'w ezau.la,em G41-�U-U?�J V )m `

2. o CJ�

3. How long have you resided in Yucaipa? Sin CA— / q U 0-0 REl~FRENCES-

1. 2.

Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: �`'� �� lG(,G(kL Date:

Z:\GENERAL SERVICES - CITY CLERK\COUNCIL, COMMISSIONS, COMMIITEES\Citi7.en Service Application.doc -52-

MOBILEHOME RENT

REVIEW COMMISSION
-53-

CITY OF YUCAIPA C ty of Vig8!y1FA,
34272 YUCAIPA BOULEVARDNOVt '1ti �0�! 14 2022
YUCAIPA, CA 92399 By:
(909) 797-2489 Gerier ll Servr s
City Clerk's Delaertment

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duty constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name orApplicant:

Address:

Nutt
Home
Phone:

Email:

Occupation:

City
Zip Code
Educational Background: "` ``)ct�WV
Commission or Committee for which you are applying: \y * (ww T)AV Vol ..........

L55
m
If you are applying to the Mobilehoe Rent Review Commission, please initial below®rsVnAtjo the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:--
Why are you interested in this position?
i�IkbUL

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL :ASSIST THE. CITY COUNCIL IN THEIR SELECTION.
-54-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualilj' you 601• selection to this commission/committee?

2. 3.

How long have you resided in Yucaipa? --`s--lam--�—Q `" ` r J REFERENCES:

2. Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa 13oulCvarcl, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of' Aj)j)1icant: �/�/�,✓�^ Date:�-
Z:IGENERAL SERVICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMITTEESUtizen Servicc Application.doc -55-

PARKS AND RECREATION

COMMISSION
-56-

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
Mo
DateCity of Yucaipa
By: NOV 1.5
(tiame)
Gel 3/
CITIZEN SERVICE APPLICATIORy Clerk's Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Conuniaces which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Denise Rae Allen
First Middle Last
Address:_ _Y,ucaipa 92399
Number and Street City Zip Code
I Iortie Work Cell Phone:

Phone: Plwne:

Irnail:

Occupation: Retired
Educational Background: Masters in Administration
Commission or Committee for which you are
applying: Parks and Recreation
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that: I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I have been an advocate for youth sports and adult recreation my entire life. I believe it is important to provide a diverse offering of recreational ammenties for people of all ages. Having served on the city council for 16 years I have a solid understanding of the parks, services and facilities available to residents in our city and a the knowledge required to provide recommendations on how to maintain, improve and grow our city parks and recreational facilities.

ATTACH A RESUME, AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE. CITY COUNULIN THEIR SF.I.EC"TION. ,
-57-

CITIZEN SERVICE APPLICATION
PAGE TN'1'O
Wbat do you consider to be three (3) major assets that would qualify you for selection to this coimnission/committee?
1- Served 16 years as an elected member of the Yucaipa city council. 2- 25+ years of involvement with yucaipa based youth sports.

3. Strong relationships with YCJUSD and CHC
How long have you resided in Yucaipa?
REFERENCES:

1. Mayor Pro Tern Justin Beaver

2. Council Member Bobby Duncan
33 years
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORTE, DING INFORMATION IS TRUE AND CORRECT. 1`
� 11.15.2022 Signature of Applicant:Date:
https:/Iyucaipa.sharepoint.com/s;tcs/Gcttcr,itServiee�Shered DocumenWGencral Ser4ces_City Clerkl@-1 C1W CLERK F1LES(COUNCI1., COMMISSIONS, COMMITTEESICilizen Sarvico Application.doc i

DENISE ALLEN-HOYT
Yucaipa, CA 92399

EDUCATION
University of Redlands, Redlands CA
Masters of Arts — Educational Administration 1997
[Thesis: "Systemic Change - Technology"]
University of California Extension Riverside, CA
Areas of Concentration: Adult Education, Educational Technology Certificate Awarded: Microcomputers for Educators 1996
CSU San Bernardino, San Bernardino CA
Areas of Concentration: K-12 Education, Mathematics
Multiple Subjects Credential 1985
Certificate: Teaching Basic Mathematics 1985
CSU Chico, Chico CA
Bachelors of Arts — Humanities 1977

CALIFORNIA CREDENTIALS
Multiple Subjects Teaching Credential:

General Subjects, Mathematics 1985 — Life
Single Subjects Teaching Credential:

Mathematics, Computer Concepts and Applications 1997 — Current Designated Subjects Teaching Credential:

Adult Basic Education, Industrial Technologies 1997 — Current Administrative Services Credential 1997 — Current

TEACHING EXPERIENCE
Crafton Hills College (retired June 2019)
Computer Information Systems Professor 2002 — 2019
Yucaipa High School
Mathematics Teacher 1994 —1998
CIS Teacher 1998 — 2002
Campus -wide IT support and Network Manager 1998 — 2002 Yucaipa Junior High
Mathematics Teacher 1983 —1994
-59-

DENISE ALLEN-110YT PAGE 2

LEADERSHIP EXPERIENCE
City Council Member, City of Yucaipa
2004-2020
President District Assembly
2017 — 2019
CHC Distance Education Coordinator
2014-2017
Mayor, City of Yucaipa
2012 — 2016
CHC Academic Senate President
2012 —2017
CHC BIET Department Chair
2010-2014
YHS Network Administrator and Technology Support Coordinator 1998 — 2002
Yucaipa High School Department Chair, Mathematics
1996 —1998
Yucaipa Junior High Department Chair, Mathematics
1985 —1994

CERTIFICATIONS
Cisco Certified Academy Instructor 1999
Cisco Certified Network Associate — CCNA 1999

AWARDS/HONORS
Cisco Networking Academy, Instructor Excellence Advanced 2017 Women of Distinction, 63`d Assembly District 2005
PTSA Honorary Services Award 2001
San Bernardino County Outstanding Mathematics Teacher of the Year 1993

COMMITTEES
Crafton Hills College
• Crafton Council
• Academic Senate
• Academic Senate Exec
• Educational Technology Committee
• Noncredit Committee
San Bernardino Community College District
• District Budget Committee
• District Strategic Plan
• District Assembly
City of Yucaipa
• Uptown Business Advisory Committee
• Youth Advisory Committee
• Economic Development Advisory Committee
• Aquatics Facility AdHoc Committee

DocuSign Envelope ID: 38C21FI:5-D8FB-4D20-9082-88335832EDEB {{ CITY OF YUCAIPA eceiErVED
I 34272 YUCAIPA BOULEVARD Cit �fitd`u�ipa
YUCAIPA, CA 92399
(909) 797-2489 110�
General Services/
CITIZEN SERVICE APPLIC%tTIONS, Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Cominittee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Tim Carlisle
First Middle Last
Address:

Yucaipa. 92399
Number and Street City Zip Code
Home Work Cell Phone: -
Phone: Phone:

Email:

Occupation:

Retried
Educational Background: AA -AS
Commission or Committee for which you are applying: Park and Rec.

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Ooeu5lpncd by:

Applicant signature:

Why are you interested in this position?

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WI-HCH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-61-

DocuSign Envelope ID: 38C29FF5-D8FB-4D20-9C82-BB335832EDEB

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission committee?

1. Experience- 22 years serviced on Parks and Rec, commission

2. Life time Yucaipa resident.

3. Works well with in the system and a good line of communication.

How long have you resided in Yucaipa? 67 years
REFERENCES:

1. Ray Casey

2. Megan Wolfe
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

DocuSfflp_nedd by:

Signature of Applicant: �' 4U Date: 9/1 a/zo2z
�sris�
Z:1GENrRAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMITI'EES%Caizcn Savicc Application.doc -62-

CITY OF YUCAIPA RECEIVED
Datc: 1 a
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 ny: 61.
(909) 797-2489 (Name)

Name of Applicant: Cathy
First
Address:

Bogh Coate
Middle I ,ast
Yucaipa 92399
Number and Street City Zip Code
Horne Work Cell Phone:

Phone: Phone:

Email:

Occupation: Teacher
Educational Background:

CWT�I—dW ELMq MSUW J135 �W 09, I.wrrnAuw tkmwa • U fa. m[d� LarbY.RlM.enrydn 1a a�. iJ en V Tmao .j—ten M19 Commission or Committee for which you are applying:

Parks and Recreation
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest. p n Q
Applicant signature:

Why are you interested in this po
As our city continues to grow I believe we ha%
r community.

While we may want to consider how we should grow to fit the needs of all stakeholders, we also need to put systems in place for sustainability in order to properly maintain the facilities we currently have.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-63-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
l . Z VtJ17•r' t� 't.t.Ji t L
,r I,iJt �Tl-1 v��L

2. 1: JA �Tld c71J Sr
GA N V iA,K) }-toff.` SAPV 0`114 L-q . o.r(L �()V-C= 7 t,tJ 1� (JL t� t f ;&:y h CJ�Tti _ cZiy ,!k Li_=1f�tZa t�3
j. Y ylt✓ �tjl,y -LN G'I,CSll4�i� P'.i�i1� jZi, bQI G i tt.C� L i t ALL: �UI: /I S G F' i,/1 W LL f fJ u iL: Nth i G��iJ Nt� t�Rl'Cz2 tt�i ttly •-j—l.vc' ►.1u frj �P,prLC_ I -low long have ou resided ill Yucaipa: --_ kC , nk t tk&0 RE
I

2. DP.-. 1y4 -- -�i� c Z�f� Uiii_��• 'VL - E ram!
I
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City Of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant:

Date:
httpsl/yucaipa.sharepoint.com/sites/GcneralScrviccs/Shared Documents/General Services —City Clerk/a CITY CLERK PILES/COUNCII., COMMISSIONS, CONIMITTEES/Citizen Service Application.doc e

EDUCATION:

Cate Boggy Coate
- Master of Education in Learning and Teaching - 2017
Cleared Multiple Subject Teaching Credential (SB 2042)
with a Physical Education Authorization - 2017
Northern Arizona Universi - Master of Education in Educational Leadership - 2001 California State University San Bernardino - Bachelor of Science in Kinesiology - 1998 Bachelor of Arts in Liberal Studies - 1998
Beaumont HiSchool - 1992

EXPERIENCE
ucaipa Calimesa Joint Unified School District Trustee December 2020-Current Inland Leaders Charter School
2010-Current
Leadership Teacher (Character Development) Grades TK-8th 2018-Current
Physical Education Teacher Grades 1"-2°'
2017-Current
President of Inland Leaders Foundation
2016-Current
Graduate Assistant for National STEM Research Project in collaboration with the University of Redlands 2016-Current
Volleyball Coach, Inland Leaders Middle School
2017-2019
Student Teaching
February -May 2017
Substitute Teacher
201 S-2017
Long Term Substitute Ist Grade (12 weeks) September -December 2016 Long Term Substitute Teacher Kindergarten (6 weeks)
August -September 2015
Instructor, Youth Basketball Electives Courses Grades Kinder-8`h 2010-2018
Stay at Home Mom
Yucaipa, California
Assistant Coach Women's Basketball
University of California Riverside
Assistant Coach Women's Basketball
Northern Arizona University
May 2007-2015
May 2004-May 2007
August 1998-March 2004
Northern Arizona University_Physical Education Department Various Semesters 2000-2004 Part Time Instructor - Courses Taught - How to Teach Elementary Physical Education; Coaching Basketball; Basketball Activity Course Camp Counselor 2000
Stanford Women's Basketball Camp Palo Alto, California July 2000 Wake Forest University Women's Basketball Winston-Salem, North Carolina June 2000 Site Director Flagstaff Family YMCA, Flagstaff, Arizona May -August 1999 Redlands East Valley High School November 1997-May 1998 Head Coach Girls Basketball Junior Varsity Squad
Assistant Coach Girls Basketball Varsity Squad
Assistant Coach Girls Softball Varsity Squad
California State University San Bernardino 1996-1998
Undergraduate Assistant Sports Information August 1996-June 1998 Representative at 1998 Regional Tournament for CSUSB Women's Basketball Team March 1998 Undergraduate Assistant Coach Women's Basketball Team August 1996-March 1997 Yucaipa, CA 92399
-65-

Cathy Tog6 Coate

TEAM AFFILLIATIONS, AWARDS, & VOLUNTEER WORK
• Volunteer Referee
Yucaipa Youth Basketball
• Board President
Inland Leaders Foundation
• Volunteer Coach
Yucaipa Youth Basketball League
• Volunteer Coach
Yucaipa-Calimesa Amaceur Softball Association Tee Ball & 61J Manager • Volunteer Tee Ball Coach
Yucaipa Youth Baseball
• Volunteer Tee Ball Coach
Beaumont Youth Baseball
• Volunteer
Rape Crisis Center Annual Auction
• Board Member
ARC Riverside
• Assistant Coach UC Riverside Women's Basketball Team Big West Tournament Championship Team • Coach of the Season
Redlands East Valley High School JV Girls Basketball
• Member
CSU San Bernardino Women's Softball Team
• Member
CSU San Bernardino Women's Basketball Team
2022-Current
2014-Current
2014.2022
2015-2016
2014
2012
2006-2007
2007-2008
2006 & 2007
1998
1996
1992-1996
• Team Captain CSU San Bernardino Women's Basketball Team 1996 • Most Inspirational Player CSU San Bernardino Women's Basketball Team 1996 SKILLS
• Helped create and implement guided, leveled reading groups as well as implemented small group tutoring, based on the specific needs of struggling emergent readers
• Organized and directed events for last day of school Field Day activities for grades TK-2^d • Managed fundraising campaign for division I college basketball program • Managed budgets for team travel, scholarships, and equipment for a division I basketball program • On -floor coaching in basketball from elementary aged children to division I college level • Directed Individual and team camps for boys and girls ages 5 to 17 • Counseled student -athletes' progress toward graduation at the collegiate level • Organized and managed team travel at the collegiate level • Organized and managed scholarship and financial aid information for student-atlletes at the collegiate level • Coordinated recruitment of student -athletes for a division I basketball program • Able to expertly utilize all programs on both a PC and a Macintosh Yucaipa, CA 92399
e

Cathy Bog( Coate

REFERENCES
Dr. Lisa Urrea - Princi al Inland Leaders Charter School A
Scott -Professor, University of Redlands
Sue Stanle - Retired Teacher, Inland Leaders Charter School - Master Teacher .c Lead Teacher, Inland Leaders Charter School - Master Teacher iDr. g"imen ezez -Director, Little Smiles Inc.

Michael Scarano - Associate Director of Athletics, California Baptist University i"Mv
yy -Director of Athletics, Saint Francis High School, Sacramento, CA Me Sanders - Retired Associate Head Coach, Arizona State University Women's Basketball Stan Morrison - Retired Director of Athletics, UC Riverside ucaipa, CA 92399
-67-

I 1JL -Al it CITY OF YUCAIPA z Lr
Cit� of Yucaipa
34272 YUCAIPA BOULEVARD ate:

YUCAIPA, CA 92399 2.022
(909) 797-2489 (ya°")
CITIZEN SERVICE APPLICAfiItiydrl<'s Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Address:

First
Number and Street
A
dle
City
s�IriJ
Last
AN
Zip Code
1-lome Work Cell Phone:

Phone: Phone:

Email: ,■.,
Occupation: Rd6J Sate; MTV) er
Educational Background: S Cjge, Cu ell roIle J-
Commission or Committee for which you are applying:

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
l�Applicant signature:

Why are you interested in this position?
� � G��'1S '� ►�ICrcci�c,� CuH+�-,� s•S,wr/'

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL, ASSIST THE CITY COUNCIL IN THEIR SELECTION.
r:

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
,�penence

3. 1
How tom, have you resided in Yucaipa? )ee.,F:

REFERENCES:

1. G6�61 00/1Ce,-�

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing, dates established.

I CERTIFY THAT TIME FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: 1t � Date: 2
ZAGE_NERAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMITTEESTitizen Service Application,doc e Us

CITY OF YUCAIPA rti:% `'�°
City of �u.,aipa
fJ Date: y:
y 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 Fjpv 2022E l
(909) 797-2489 (Natne)
CITIZEN SERVICE APPLICATION Clerk's DPhart►„er,1
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in frill. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Address:
i�-L L- S
First Middle Last
Number and Street
Home Work
Phone: Phone:

Email:

Occupation: 7-51A
Educational Background:

NEyu�.9 ��3��
City Zip Code
Cell Phone-
s i •JESS Ou/N rc'
161
Commission or Committee for which you are applying: C-Q tZ e d9 % / OA1 If you are applying to the Mobilchome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilchome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehorne or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
PK dy P (7 7 n r4 T o ry 4
ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICI•I YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.

SFAIsE, OF C-r lc /DUTY.
014
S
-70-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. �� '�� S'S F S S i9 Z-D Al l

2. �3 G- A2
sI Al r-,��vG, a blAJ6 ,vT
How long have you resided in Yucaipa? j V 0-1 ..S
REFERENCES:

1.d

2. 19? T" G.

A r_ �J-i? .

Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of' Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THATTHE FOREGOING INFORMATION IS TRUE AND COI2RL'CT.

Signature of Applicant: f�y.. `��l� Date: % 2
ZAGENERAL SERVICES - CITY CLIiRK1C0UNCIL, COMMISSIONS, COMMITITESICitizen Service Application doc -71-

Received
CITY OF YUCAIPA Cif3FWwcai
Dale:
34272 YUCAIPA BOULEVARD DEC 0 8 20Z
YUCAIPA, CA 92399 By: --
(909) 797-2489 f (Name)
.er-vic
City Clerk's Department

Name of Applicant:

Address:

Home
Phone:

Email:

Leonard C LaRocco Jr
Middle Last
First
Yucaipa 92399
Number and Street City Zip Code
Occupation: Manager _ _
Work Cell Phone:

Phone:

Educational Background: undergraduate _T
Commission or Committee for which you are
applying: Parks and Recreation &Trails and open spare
If you are applying to the Mobilehomc Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code $15.20.070, Subsection A (1)) 1 declare that I am neither a resident nor a park owner of a mobilchome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilchome or mobilchome park anti ha c no parcnta, children, spouse or siblings with any such interest. j
Applicant signature: 1-(," N_
Why are you interested in this posit'
I am an avid mountain biker whom enjoys our local trails and parks.

Being a Ion term resident I want to be sure the trails/parks will be protected and used responsibly
ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL N'1111- ASSISTTHE CITY COUNCIL IN THEIR SELECTION.
-72-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to.be three (3) major asses. that would qualify you for selection to this commission/committce?
l Analytical and detailed driven
2• Team player

3. Punctual and dependable
Flow long have you resided in Yucaipa`'
REFERENCES:
l Chris Venable
Heather Van Grouw
47 years
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be rehimed to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOE G INFO IMATI N IS TRUE AND CORRECT.

Signature of Applicant: U Dale: 1 Z b W_z__
h11p�:r/yucuipnshutapoinl.corn/silCslGener:d5erviees.ShaceJ Docwnems General Scrvicec City Clerkt,' CITY CLERK 1.1LLiS MUNCIL.

COh1AnSSIONS. COMMITTFMCiuzen Service Application doe
-73-

rf '' -CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD Ci
YUCAIPA, CA 92399
(909) 797-2489
Recel c@tvsD
%Pd.- Yucai jW)
ff1
General Services/
CITIZEN SERVICE APPLIC,.hM- t i 's, DPI?artment
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in Rill, The applications should be typed or clearly printed and filed with the City Cleric,
Name of Applicant: Erik V. Sahakian
First _ vliddlc Last
Address: Yucaipa, CA 92399
Number and Street i~ City Zip Code
I Inmc
Phone:

E-mail:

Work
Phone:

Occupation: Labor relations
Cell Phone;
Educational Background: Business administration and government Commission or Committee for which you are applying: Parks and Recreation If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City ofYucaipn Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I have a strong desire to serve and protect our community; to preserve it for future generations. I believe our parks are an integral asset and recreational community activities are vital to the life of our city because they both provide the means and opportunity for people to feel connected, to enjoy spending time together, and to be reminded of what we all share in common. ;ATTACK A RESUIIIE AND/OR ADDITIONAL INFORMATION . WHICH YOU FEEL WILL ASSIST TIiC CITY COUNCIL IN. -THE IR SELECTION.
-74-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
1 A history of service to the citizens of Yucaipa as a businessman, pastor, and elementary school -teacher in our community.
2,
3 A solid business background, both in self-employment and corporate, as well as non-profit and government.

A strong educational background with both a M.B.A. and a B.A. in Political Science with a concentration in Public Administration. 1-iow long have you resided in Yucaipa? 16 years
REFERENCES:
1 Mike Cowen
2• Jason Talley
Applicants are advised that they may be requested to make inCormation available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, Californin 92399, prior to ally closing dates established.

I CERTIFY THAT THE FORE, GOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant:

Date: 11-11-22
ZA013NERAL SERVICES • CITY CLERIOCOUNCIL, COMMISSIONS, COMMITTEES01inn Service Applicnlion.doc -75-

Pagel of 3
Erik V. Sahakian Mobile:

Email: -
Yucaipa, CA 92399

WORD EXPERIENCE
Field Representative, California Correctional Peace Officers Association Rancho Cucamonga, CA (April 2022 — Present)
• Act as chief negotiator for all statewide negotiations in Sacramento. • Represent the organization at all locally assigned monthly chapter meetings. • Write appeals and arbitration recommendations for member grievances. • Regularly visit 4 assigned prison institutions in Southern California region. • Provide labor relations training to members and staff.

Adjunct Professor, Community Christian College
Redlands, CA (March 2018 — Present)
• Teach online business classes for up to 50+ students. • Create and develop over 10 unique online business courses. • Administer and grade student research papers, tests, and projects. • Provide ongoing LMS training to faculty and other staff.

Owner, Abundant Harvest Publishing
Yucaipa, CA (October 2017 — Present)
• Provide editing, formatting, graphic design, and publication of manuscripts. • Manage 4 independent contractors.
• Released over 30 books by various clients for sale on Amazon/KDP. • Direct clients with marketing strategies resulting in over $100,000 in book sales.

Administrative Pastor, Wildwood Calvary Chapel
Yucaipa, CA (February 2012 — April 2022)
• Assisted in running the daily operations of a 3,000-member church. • Oversaw a volunteer team of approximately 200 volunteers. • Supervised 7 staff employees.
• Administered the operations of over 20 different ministries. • Developed, oversaw, and taught the School of Discipleship. • Provided pastoral oversight of Wildwood Christian Academy and Middle School.

Electives Teacher, Inland Leaders Charter School
Yucaipa, CA (January 2012 — May 2018)
• Taught elementary level computer literacy for over 100 students. • Taught electives such as journalism and creative writing. • Provided intervention classes for struggling students. -76-

Page 2 of 3 ends

Substitute Professor, United Education Institute (UEI)
Inland Empire, CA (January 2010 — October 2012)
• Taught business classes for up to 35 students.
• Administered tests, student projects, and field trips. • Took attendance, posted grades, supervised labs.

Field Representative, Insurance Services Office
San Bernardino County, CA (January 2007 — March 2012)
• Responsible for San Bernardino County territory.
• Performed over 1,000 inspections of commercial and habitational buildings for dozens of insurance carriers.

Trained in building construction, automatic hydraulic fire sprinkler systems, insurance rating, and commercial underwriting inspections.

Owner, Provident Investor Services/Earras Corp.

Upland/Riverside, CA (July 2006 — December 2011)
• Managed al l day-to-day operations of the company.
• Negotiated client contracts and leases.
• Developed direct mail advertisements and the company website. • Managed caseload of over 100 residents.
• Supervised all property repairs and performed regular quality inspections. • Managed accounts payable and receivables.

Property Manager, Housing Authority of the County of San Bernardino Colton, CA (September 2002 — July 2006)
• Supervised 8 employees.
• Performed over 2,000 physical inspections of rental properties. • Managed over 50 government subsidized rental properties in 6 different cities. « Prepared and managed annual budget totaling over $1.4 million. • Procured over $300,000 of CDBG funds for improvements of local communities.

Occupancy Technician I & II, housing Authority of the County of San Bernardino Ontario/San Bernardino, CA (June 2000 - September 2002) • Supervised 2 full-time employees.
• Developed and launched new Section 8 applications department at local office. * Managed an assigned caseload of over 300 program participants. • Taught group orientation sessions regarding policies and procedures. • Performed housing inspections of subsidized rental units.

Project Support Specialist, HealthMed Services, Inc.

Whittier, CA (March 1998 - February 2000)
• Created reports that tracked over $36 million in annual gross revenue. • Performed analysis resulting in the recovery of $100,000 in lost revenue, • Created and analyzed reports tracking financial trends and variances. • Negotiated the dismissal of over $150,000 in disputed accounts payable. 2 -77-

Page 3 of 3 ends

Administrative Intern, City of Yorba Linda
Yorba Linda, CA (December 1996 — March 1998)
• Assisted in the development of the annual budget.
+ Conducted job reclassification studies.
• Created Standard Operating Procedures for the City's Emergency Plan. • Drafted recommendations to the City Manager and City Council.

EDUCATION
2003 University of Redlands - Alaster of Business Administration 1999 California State University, Fullerton - Bachelor of Arts in Political Science with an emphasis on Public Administration
1996 Mt San Jacinto College -Associate ofArts in Social and Behavioral Science

ACCOMPLISHMENTS
• Weekly columnist for the Yucaipa/Caliinesa News Mirror (2017 to present). • Author of four books; Attitude is .everything (2021), Don't Worry About a Thing (2019), Check )'ourself Before You ff reck Yourself (2016), and Shadowlands to the Songs of Seraphim (2013).
• Candidate., Yucaipa City Council (2022 and 2008).

id
s

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
Ci
ecelW&iVED
t 8 Yucaipa
a e:
0 CITY:0 5 ?n?9
(Name)

Name of Applicant: Douglas R Witham
First Middle Last
Address: Yucaipa 92399
Number and Street City Zip Code
Home Phone: Work Phone: Nan Cell !'hone: _.

Email:

Occupation: Retired Firefighter
Educational Background: Some college
Commission or Committee for which you are applying: Parks and Recreation Commission Why are you interested in this position?
Enjoy outdoor recreation. Like helping people learn about our parks What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Helped build several parks.

2. Worked outdoors for 18 of my 35 years for the state.

3. Can work with inmate handcrews

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE Crn.' COUNCIL IN THEIR SELECTION.
-79-

CITIZEN SERVICE APPLICATION

PAGE TWO
How long have you resided in Yucaipa? 28 1 /2 years
Are you a registered voter? 0 YFS ❑ NO
REFERENCES:
1 Bill Davis
2 Mike Morrell
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established, I CERTIFY WHAT THE FOREGOING INFORMATION JS TRITE AND CORRECT. r
Signature oi'Applicani: ( , Date: l� / �� L
For Office Use Only
Appointed to:

Appointed by:

Date Appointed:

Termination of Appointment:
11COYF MityCleffiGENERAL SERVICES -CITY CLERKICOUNCIL, COMMITTEES & COMMISS10NS1Citizea Servicc Application.doc OM

PLANNING COMMISSION

` CITY OF YUCAIPA ABRVI d
i 34272 YUCAIPA BOULEVARD DiQit Qf Yi r
YUCAIPA, CA 92399 By.
(909) 797-2489
(3eneral Services/
CITIZEN SERVICE APPLICATIONCIerk's Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Conunittee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Gerald Robert Allgower
First Middle Last
Address: Yucaipa
Number and Street City Zip Code
Home
Phone:

Work Cell Phone:

Phone:

Email:

Occupation: Self employed
Educational Background: 2 years College
Commission or Committee for which you are applying: Planning Commlttes If you are applying to the Mobilehome Rent Review Cominission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no Financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in 's posit on?
Ive built a few homes and have gotton entitlements on vacany land as well,feel i can be of asset to this committe

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST TILE CITY COUNCIL, IN THEIR SELECTION.

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this cominission/committee?
I. I work in town

I' VE BUILT HOMES
1 have done entitlements on vacant J, 6L1j
How long have you resided in Yucaipa? 1988
REFERENCES:

1. BOBBY DUNCAN

2. Jon Thorp
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT TIME FOREGOING INFORiMeMON IS TRUE AND CORRECT.

Signature of Applicant: Date:

ZAGENERAL SERVICES - CITY CLERKICOUNCIL. COMMISSIONS. COhIN1IT7EES%Citizcn Scrvicc Application.doc NoM

DocuSlgn Envelope ID:47D8FOB7-FQ44-,1Df=4-8Ba;9-ssoo12ED7FB5

CITY OF YUCAIPA RECEIVED
Dapeceived
i 34272 YUCAIPA BOULEVARD City of
YUCAIPA, CA 92399 By:
(909) 797-2489 SEP 2+N22
eral Services/
CITIZEN SERVICE APPLICATIO ,�Y1,�
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Richard :vlichacl Beck
Name of Applicant:
}First Middle Last
Address: Yucaipa 92399
Number and Street
Home Work
Phone: Phone:

Email:

Occupation: Contractor
Educational Background:

K-12 associate's degree trade school certs
City Zip Code
Cell Phone: -
Commission or Committee for which you are applying: planning Commission If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

DoeuSfpned 6y:

Applicant signature:t�
Why are you interested in this position?
ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL «'ILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
t

9. DacuSign Envelope ID, 4708FOB7-F044-4DF4.8B49.650012ED7FB5

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this conunission/committee?

1. Familiar with the general plan.

2. 1 have an open mind with what happens in our city.
3_ Have served on the commission for 2 years.

How long have you resided in Yucaipa?
I-.EFERENCES:

1. Justin Beaver - City Councilman
19 years

2. Kenny Rice - Owner of American Eagle Constrution
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or- investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORE GOING INFORMATION IS TRUE AND CORRECT.

Uocustgned by:

Signature of Applicant: E---=1R9GMrR1b-

ZAGENERAL
in

Receivecl
CITY OF YUCAIPA City °ct-r�<=� \
Date:
34272 YUCAIPA BOULEVARD NOV 2i
YUCAIPA, CA 92399 BY:
(Nome)
(909) 797-2489 Ge feral Service
City Clerk's Dehrjrtment

Name of Applicant: Bart William Brizzee
First Middle Last
Address: Yucaipa 92399
Number and Street City Zip Code
Home Work Cell Phone:

Phone: Phone: NA
Email:

Occupation
Retired
Educational Background: AA, BS, JD
Commission or Committee for which you are
applying: Planning Commission
If you are applying to the Mobilchome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I. declare that i am neither a resident nor a park owner of a mobilchome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilchome or mobilchome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
would like to continue my service to the community by helping to implement the overall vision and land use policies of the Citv Council.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL.

ASSIST THE CITY COUNCIL IN THEIR SELECTION.
:•

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
L Experience. Eight years on the Planning Commission, 15 years as the primary legal advisor to San Bernardino County planning.

2. Judgment. Thirty-six years as practicing attorney has required refined judgment and balancing of competing interests.

3. Community Interest. Resided here since 1987, presently retired here.

How long have you resided in Yucaipa? 35 years
REFERENCES:

1. Travis Salisbury, CPA, Yucaipa 92399

2. Jeff Erickson, Attorney, Yucaipa 92399
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE, FORE, GOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: l/Lt'/ Date: 11.21.2022
Lu_..//......_:_....L.._.._,.:..1...._.1..:.....li•.._......tn.._.:.. .._M1.. _.J T__ ...._..._In ....._. 1 0-1,:—nl__I.//.l P1Pr•l/ I•r r'7r)V lar IMP /nnT nlnn -O / -

Received �..

City of Yucaipa --'
CITY OF YUCAIPA=CGtVGD
6` Date: `l
i 34272 YUCAIPA BOULEVARD
Gen vices%' YUCAIPA, CA 92399 " }"
City Clerk's Department (909) 797-2489 (NAt1C)

Name of Applicant: �1w i i J„ w, 12) u r rf ,-I, P
First Middle Last
Address:WIU OLUCUL �, �, ; ne- % A3 Q 9
City Zip Code
I tome Work Cell Phone:

Phonc: ]'hone:

Email:

Occupation: Cj�, o •n Yv�C v. c C,. c?-� I rS �nr �� -+�'on Corn Educational Background: l
Commission or Committee for which you are applying:

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
ATTACH A RESUME AND/OR ADDITIONAL INI+ORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THE.ER SELECTION.

CITIZEN SERVICE APPLWATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
3' 1- JI%T e,4(-P/�( t^ i`�e t toLA✓ -�. o {� rJIJ(
How long have you resided in Yucaipa?
REITLRLNC1 S:

2. Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/propert), and/or investments with the City Of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT TIME FORGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: a—, 9--- I Date: % ,26 22
ZAGCNERAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMIT ECSNCitizen Service Applicatim.doc is

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
Gjr'v of Yucaipa
re
CITIZEN SERVICE APPLICATiONlerws Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Tony G. Hicks _
First Middle Last
Address: Yucaipa CA 92399
Number and Street City Zip Code
Home Work Cell Phone:

Phone: I'honc:

Email:

Occupation: business owner
Educational Background: fourty years of contracting
Commission or Committee for which you are
applying:

Planning Commision
If you arc applying to the Mobilchome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20,070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobiiehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilchome or mobilchome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
Current member of the commision

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
•E

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to bo three (3) major assets that would qualify you for selection to this commission/committee?
1, Development experience
' Construction experience

3. business owner
How long have you resided in Yucaipa?
REFERENCES:

John Thorp
Ben Matlock
40 years
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: Date:
hops:/tyucaipa.sharepoint.coin/sitcslGencralServic&Shared DocumentstGencrnl 5ervic City Clark! 0a CITY CLERK FILESICOUNCIL, COMMISSIONS, COMMITTEES/Citizen Service Application.doc -91-

Received

CITY OF YUCAIPA
j ! 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
Ci
Cityuca.VV. vD,a►pa
► ate:

OCT—M
By:

Genet-PS8rvicesl
tyClerk's Deoartnie

Name of Applicant:

Address:

David Wayne Higginson
First Middle Last
Number and Street
Home Work
Phone: Phone:

Email:

Occupation: Architect
Educational Background:

Yucaipa, California 92399
City
Cell Phone:

Zip Code
BS Business & Management / MS Theological Studies
Commission or Committee for which you are applying: Planning If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilchomc park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilchomc park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I have been a practicing architect for 38 years and have successfully completed well over 3000 projects during my career. Having been a resident of Yucaipa for the last 6 years, I have grown to love the community and the vision it has to maintain it's small town allure. I have desired to serve on a planning commission for years and feel, at this time in my career, I can give back to my community.

A'17FACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
,it
-92-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Practicing California architect since 1988. Currently hold licenses in 7 states Past president of the AIAIC (American Institute of Architects Inland Chapter) 2• Moving my practice to the City of Yucaipa in October. Currently working on several projects within the City of Yucaipa and understand the permit and planning process

3. 1 have been active in the State of California licensing process for architects for almost 20 years serving on numerous committees.

How long have You resided in Yucaipa? Approximately 6 years REFERENCES:
1 Bud Thatcher
Brian Burson
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUI', AND CORRECT. 09/30/22
Signature of Applicant: Date:
%•1GENERAI. SERVICE'S - CITY CLERKICOUNCIL, COMMISSIONS, COMMr[TI:ES\Citizen Service Application doe -93-

CITY OF YUCAIPA [ I�l�
13ri, of Yucaipa
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 t3)ICT—�z2—
(909) 797-2489 (tvtunc)
CITIZEN SERVICE APPLICATiIM'erk's Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in till. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Brian
Robert Lowell
Dint diddle last
Address:

Number and Street
Home Phone: N/A
Yucaipa, CA 92399
City
zip Code
Work Phone: Cell Phone:

Email: _
Occupation: Civil Engineer
Educational Background:

Bachelors Degree in Civil Engineering - Cal Poly I'onuma Commission or Committee for which you are applying
Why are you interested in this position?
Planning Commission
I hope to become more involved in the community and help Yucaipa be the best city that it can be.

I believe that the Planning Commission is the perfect opportunity ror a resident to become involved in local government and help shape the future of the City.

What do you consider to be three (3) major assets that would qualify you for selection to this conunission/conunittee?
I I have five years of experience as a planning commissioner in the City of Moreno Valley. 2• lam a licensed Civil Engineer with over 20 years of experience.

3. f am very familiar with the entitlement process and the role local government plays in this process.

ATTACH A RESUME AND/011 ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.

CITIZEN SERVICE APPLICATION

PAGE TWO
Flow long have you resided in Yucaipa? 4.5 YI-I'ARS
Are you a registered voter? 0 Yt?S ❑ NO
REFERENCES:
t Patricia Korsick,-1
o Richard Sandzimicr,-
Applicants arc advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT TIME FOREGOING INFORMATION IS TRUE AND CORRECT.

Al
"P/Signature of Applicant: Date: I0/3/2022
For Office Use Only
Appointed to:
,appointed by:

Date Appointed:

Termination of Appointment:

I\COYI'SI%CityClcrk',(;LNI:RAL St:RVICI:S- CI1T CLI.RKWOUNCIL, CONVAHTU iS S COMMISSIONSTitizen Service Application.doc -95-

DocuSign Envelope ID: 414D5C31-F125-485F-8CD3-7EA6793CFDt34 CITY OF YUCAIPA c t ofI C ip
y ucaialpa
Date:
lot th 34272 YUCAIPA BOULEVARD U 02-2022
YUCAIPA, CA 92399
(Name)
(909) 797-2489
City Clerk's Department

Name of Applicant: Christopher Vrej Markarian
First Middle Last
Address: Yucaipa 92399
Number and Street
Home Work -
Phone: 1111c7nc:

Email:

Occupation: Attonrey
Educational Background: AA, As, BA, MA, JD, PhD Candidate City Zip Code
Cell Phone: -
Commission or Committee for which you are applying: Planning and EDAC If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
f fooc_uslpnad by:

Applicant signature:'
Why are you interested in this position?
ATTACH A RESUME AND/OR ADDITIONAL INFORMATION W[IIC11 YOU REh;I, WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
e

DocuSign Envelope 10: 41405C31-F125-485F-8CO3-7EA6793CF0E4

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Invovlement in other areas in the City of Yucaipa

2. Education
3, Work Experience
How long have you resided in Yucaipa?
REFERENCES:

1. Ray Casey
1) David Avila
10 years
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORitiMTION IS TRUE AND CORRECT.

OocuSigned hy:

Signature of Applicant: F date, 10/31/2022
Z:\GENERAL SERVICES- CITY CLERK=LJNCIL, COMMISSIONS, COMMITTE-EMCitizen Service Application.doc -97-

CITY OF YUCAIPA C11W8FVt)caip-
Date:
34272 YUCAIPA BOULEVARD OCT 121022
YUCAIPA, CA 92399 By:
(909) 797-2489 Ge:n6VANervices
;�
City er s Department

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Conunittee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: S� �� I' 1 � CY-2 .4'3 '1
First Middle Last
Address: CA
Number and Street 'ity Zip Code
Home Work Cell
Phone: Phone:

Email:

Occupation: `1�\ Vim` :A. t-lc � ) Q G e
Educational Background: V 5 __( C g Cl(
Commission or Committee for which you areapplying:

If you areapplying to the Mobilchome Rent Review Commission leas initial below pursuant to Y �p
the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSISTTHE CITY COUNCIL 1N THEIR SELECTION.
•3

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/conin- ttee?

1. I" 1
� i'c:Ue rV o.i mot_ clu Jf Tf� 2sil "A— 1 LQ,1 4%,j VC71,1C Yp'.-k--01-3 s-= How long have you resided in Yucaipa?
REFERENCES:
2-
} j O
C� I'ti
?IC
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING LNFORMATION IS TRUE' AND CORRECT.

Signature of Applicant: �� Date:

Z:IGENERAL SERVICES - CITY CUMCOUNCIL, COMMISSIONS, COMMMEESTitizen Smiee Application.doc ••

CITY OF YUCAIPA
DateCity of Yucaipa
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 DESQ1. 2022
(909) 797-2489 (Name)
Clerk's Departt�ie nt
CITIZEN SERVICE APPLICATId
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in frill. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:�L—JV.��j.5
First Middle Last
Address:

Number and Street City Zip Code
Home
Phone:

Email:

Work
Phone:

Cell Phone -
Occupation:

Educational Background:G'.131��s9
Commission or Committee for which you are applying:

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) 1 declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest. Aw',
Applicant signature:

Wily are you interested in this position?

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-100-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
How Iona have you resided in Yucaipa? ,,�� YA j
REFERENCES:

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: �,(�!%� Date:i�'��/��
ZIAGENLRAL SERVICES - CITY CLERK,.000NCIL. CONEMISSIONS, COMMITTEEMCitinn Service Application.doc -101-

Application for Planning Commission of the City of Yucaipa I, Dennis Miller, have been a resident of the Yucaipa Valley since 1963. I have attended all my education through the Yucaipa School District.

As a lifelong resident in Yucaipa Valley, it has given me the opportunity to see Yucaipa change and gives me knowledge to help shape Yucaipa for the future without forgetting the past.

I am a Real Estate Broker for the last 41 years and have helped hundreds of families with there real estate needs. I have lived in over SO homes in Yucaipa Valley from one end to the other. I know this Community like the back of my hand.

Past Community Involvement
• Past President of Yucaipa Chamber of Commerce
• Past President of Yucaipa Valley Board of Realtors
• Past Member of the first General Planning Committee of Yucaipa • Past Planning Commission Member in 2 different terms
• Past Planning Commission Chairman
Please call me if you have any questions. Thank you for your consideration.

Dennis Miller
-102-

Aullwntl;Ign Ill: lE2021C7•r IJA1.41331-834F48COBCO2A303 t�Rdi

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 G
it� nof Yucair
te:

ITV 15 2022
(Name)
CITIZEN SERVICE APPLICA'C�-k"' Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Kristine K. Mohler
First Nl idd le Last
Address:

Home
Phone:

Email:

Yucaipa, 92399
Number and Street City Zip Code
Work
Phone:

Occupation: Real Estate Broker
Educational Background: B.S. UC Davis
Cell Phone:

Commission or Committee for which you are
applying: Planning Commission
If you arc applying to the Mobilehome Rent Review Commission, please initial helow pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in tine City of Yucaipa, that 1 have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
�.uw�w, ws�• �� oa+.wi dr t.n..ry �w•ur � a � cx„ n...r.y t+.n,. wt •. fn e.-u.y.w.h.v.n. e..n.,., am..x.., y.�e•,o...x t n......,�e m ....r� mwn.wx. W us,c�xrm avw n.a,.x. •r.t+eat t u. v.uxa m woo.wa•

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-103-

Authentlsign 10: tE2Q21C7,FBA1.4B38.834F.48C9BC92A303

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
I. Living in Yucaipa for over 30 years and being active in City Committees I Being on the General Plan Advisory Committee cave me great insite from the requirements of Sacramento to the vision of our future

3. .11Pn ChWf of MO Tusi Pnd CrOn Spt:n VVMMD tin 0'p,--fly to«uaala%,h rany WIMA Y-1p, . TM ntnhrozon null Wv c..r:C, 1cl eir Ar,•n'Cbntlnr :;tr h:n lrovn-IOWVro7nailal.3— How long have you resided in Yucaipa? over 30 years
REFERENCES:

1. Dick Riddel, Denise Allen, Greg Bogh, Fermin Preciado, Jennifer Crawford, Megan Wolfe

2. The entire Trails and Open Space Committee
Applicants are advised that they may be requested to snake information available regarding any potential conflict of interest arising from their busitess/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT. ut�.cnli,t< Signature of Applicant:Date: 11 /01l23
tt1t;i2022 1:32.47 AM OW
hops:l(yucaipa. sharcpoint. ConVsites!GeneraIServiccs/Shared Documents!Gencral Services —City ClerW@j) CITY CLERK FILES/COUNCIL.

COMMISSIONS. COMMITTECWS!Citizcn &rvice Application,doc -104-

CITY OF YUCAIPA Cit of Y8ECJjV§D
lift,iti 34272 YUCAIPA BOULEVARD Dais:
! )
YUCAIPA xy
CA 92399 1 4 2022(Name)
(909) 797-2489 Genf ral Services(
City Clerk's Department

Name of Applicant: \�VVp,\ & wlytUky�&_Y\
First 0 Middle Las
Address:

Home
(_ Phone:

Lima&
Occupation:
5 i t
C)A �,:�
Number and Street City Lip Code
Educational Background:
j
Commission or Committee for which you are applying: 6" � If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Whv are you interested in this nnsitinn7
ATTACI3 A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-105-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

2. 3.
f
b V
�cw- t5n i
I -low long have you resided in Yucaipa?
Rl ;FI;RI NCT;S:

2. 00�
��IVUU- �A9- --
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORI2EC1'.

Signature of Applicant: �—��/i /�• I:)atc: ,
1�
ZAGENERAL SERVICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMITrEEMCitizen Servicc Applicotion.doc -106-

Received
CITY OF YUCAIPA City or
34272 YUCAIPA BOULEVARD i� Ot I jf
YUCAIPA, CA 92399 By: �
(909) 797-2489 Gen raj Se Nanck�s/
City Cler < S Departaient

Name of Applicant:

Address:

L It yd, 72"A }� l� t~�-
First Middle Last
C22�
Number and Street City Zip Code
Home Work Cell Phon�
Phone: ../ Phone:

Email: I
Occupation: R ( ✓l I I— e
Educational Background: , ,_�C��,QJQ �j?I11�/
S//�i I Z1�7 ,
011A SAGGll
Commission or Committee for which you are applying:
�I��i? /%�
C.��l/17 /�� i •ss /CJ f7
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehomc park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

W�l are you into vested in this position?
I / /`''/Git�%C-r
ATTAChI A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-107-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
I-Iow long have you resided in Yucaipa?
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORE NG INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: %l ( ! /'� Date: % ZU 2 a
L.

ZAGGNGRAL SERVICES - CITY CLGRKICOUNCIL, COMMISSIONS, COMMITTEEMitizen Service Application,doc

DocuSign Envelope ID:44DGF43F-9484-4C74-9A8D-DF79Ao99ElB8 got CITY OF YUCAIPA
:a 34272 YUCAIPA BOULEVARD
y YUCAIPA, CA 92399
(909) 797-2489
CITIZEN SERVICE APPLICA7

RECEIVED
Ity oM, Icaipa
By:

NOV 14TR2
II JCI vll,. Car
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions -and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Cesar Roldan
First Middle Last
Address: -_Yucaipa CA 92399
Number and Street City Zil) Code
Home Work Cell Phone -
Phone: Phone:

Email:

Occupation: Realtor and Wine Grape Grower (viticulturist) Educational Background: Bs in Business Admin, Frilrepreneurship & Marketing Commission or Committee for which you are applying:

Planning Commission,9`ucnipa•winc�'Cotmtry.PC
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
cuSlgned 6y:

Applicant signature: F�S"" Au.,
Why are you interested in this position?
I am interested in these positions because I can bring a unique contribution as Family man, business owner and minister.

My wife and I fell in love with this town and community and feel the responsibility to contribute to the beauty, growth, and thrive of it.
:ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WINCH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-109-

DocuSign Envelope 10: 44DCF43F-94E4-4C74-gABD-OF79A099E1B8

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. 1 have learned and developed the ability to work hard and complete tasks at hand.

2. 1 research in order to be informed and educated before making decisions.

3. As a business person I am a problem solver and have the ability to see beyond the immediate and come up with win -win solutions.

How long have you resided in Yucaipa?
REFERENCES:

1. Bobby Duncan

2. Ray and Donna Snodgrass
4 years
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

DocuSlgned by:

Signature of Applicant: �GSaI^ �Date:
11/10/2022
Z:IGENERAL SERVICES - C1TY C1.13MCOUNCIL, COMMISSIONS, Scrvicc Application,doc -110-

Received
' CITY OF YUCAIPA City of
34272 YUCAIPA BOULEVAI&NOV
YUCAIPA, CA 92399
(909) 797-2489 General
City Clerk's
By:

Servic�.��1

Name of Applicant:

First C/ Middle Last
Address:

Number and Street
Home Work
Phone: Plione:

Email:

Occupation:

Educational Background:

Commission or Committee for which you are applying:

Cell
Zip Code
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:"1 f C'fL1 �tp/LGJGG�...l
Why are you interested in this position?
o Itil Io�t��r {� IG �i ,-?c , a— VV ee— .mac
C:�iv G'�iGacc�<�<�,-i�%t,�-' /�ed,�on�'7,i�e�. �•G/�-i�-��-� �3'oGJ� ATTACH A RESUNIPA M/OR A19DITIONAL ROORMAJMN WHICU YOU FEEL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-Ill-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you Im- selection to this commission/committee?

1. At vo —r-, a (u-f 61;� d - 4a, tv. vl,) ih � clez.�fz S)rr(z- dy. el? 0_wd It"'tc (-y,
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa 130ulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of'Applicant: �M.•/C'1�,��/1 Date: / I /-)-c) �1 ZAGENERAL SERVICES- CITY CLERKICOUNCIL, COMMISSIONS, COMMITTEESWilizen Service Application.doc -112-

MAN
CITY OF YUCAIPA city of Yucalf
Inc 34272 YUCAIPA BOULEVARD fin,
3 2022
YUCAIPA, CA 92399 �� (Name,
'
(949) 797-2489 Gen a
City Clerk's Department

Name of Applicant:

First
Address:

MUMWanSti
Home
Phone:

Email:

Occupation:

Educational Background:
'�'7 _1
Middle L st
Y1A0,2)jP. qi
City Zip Code
Work Cell Phone:

Phone:

Commission or Committee for which you are applying:

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehomc park and have no parents, children, souse or siblings with any such interest.

Applicant signature: I jq
Why are you interested in this position?
4;-0

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-113-

CITIZEN SERVICE APPLICATION
'PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

2. How long have you resided in Yucaipa? 4- `n_-
REFERENCES:

2. -�
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORE, INFORMATION IS TRUE AND CORRECT. \ % r•,
Signature of Applicant: t` �) ��,, Date: i' ldi b� ,�
r
ZAGENERAL SERVICES - CrrY CLERKICOUNCIL, COMMISSIONS, COMMITTEES\Citizcn Scrvicc Application.doc -114-

SM CITY OF YUCAIPA 1RECENLD
Da e: Ceivc-,r l
34272 YUCAIPA BOULEVARDIT ilY of
YUCAIPA, CA 92399 BY•NOI�t''�"��?.0
(909) 797-2489
CITIZEN SERVICE APPLICATIU,,r'Pr `ri Service, .

The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Ian M. Tillen
First Middle Last
Address: Yucaipa 92399
Number and Street City Zip Code
Home
Phone:

Work
Phone:

Cell Phone:

Email:
occupation: Material Operations Senior Specialist - SCE Educational Background: Some College / Trade
Commission or Committee for which you are applying: Planning If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilelionie park and have no parents, children, souse or siblings with any such interest,
Applicant signature:

Why are you interested in this position?
I am interested in joining the planning committee because I love Yucaipa, and feel I can offer some helpful perspective. Being a resident of District 5 Wildwood, I would like to lend mV perspective on development plans and opportunities for the area in particular.

I like the uptown renovations, and a more connected community.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-115-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
l My construction background gives me a realistic perspective on proposed development, possible issues, and unique insight.

2. 1 am a vested community member, who values what Yucaipa has to offer, and a keen interest in the direction it will go.

3. My general disposition is measured, and thought out. Friends and family would say I'm detail oriented, and do not cut corners.

How long have you resided in Yucaipa? 24 Years
REFERENCES:

I. Jason Ross -

2. Brandy Gomez, CLPF, NCG -
Applicants are advised that tile), may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business Jr affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa. California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORNIATION IS TRUE AND CORRECT.

Signature of Applicant: Date:
71( IA—RAI SI•ItVICI'S • CI rY C I.I:RKICOUNCII.. CO\INIISSI(:)NS. C(1NINIII'1l 1•SkClu.-cn Sen icc Application doe -116-

IL CITY OF YUCAIPA
fl 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 G
,ity of YUGEI PE1
DAAatt�o:

H�Q� `c�
(Name) --1
r-
CITIZEN SERVICE APPLICAfibwrk's Department
The Yucaipa City Council is seeking citizens to serve oil duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in frill. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: �l. L k, Jluw2 nti UVIL C i C k
Firs Middle Last
Address:WM'=— I W VuCAI C17 3 '
City Zip Code
Home Work Cell Phone:

Phone: Phone:

Email:

Occupation: _ oo �t�U V - I n_
Educational Background:

Commission or Committee for which you are applying:

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that 1 have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
lb (YL
Cy�51I-trGLUh � -6 4.
�v0-u-�r� 1 �2.ti- ��-o G�t�t 1t�Q-tti l�- �- �Ir�CI"! ►,... , -v-Y th.c��' �� ,ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ;ASSIST THE MY COUNCIL IN THEIR SELECTION.
-117-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you !or selection to this commission/co m nu tte e?
I. 'ea S e"I -dVf" l Zc 1ti.� t
2, a`�"if F C1
C c,
blow long have you resided in Yucaipa?�
REFERENCES:

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT TIME
Signature ol'Ahplicant:

ID CORRECT.

Date: 11 Z z
ZAGENERAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMITTEES1Citizen Scrvicc Application.doc -118-

CITY OF YUCAIPA RECEIVED
34272 YUCAIPA BOULEVARD Date:

YUCAIPA, CA 92399 Ey j 6, '
(909) 797-2489 1
(Name) V

Name of Applicant:

First Middle
Address:

Home Work Cell Phone:

Phone: Phone:

Email:

Occupation:
1- ducational Background: ��-�'
Commission or Committee for which you are applying:r.�..u-z- fig.• If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code 515.20.070, Subsection A (l)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
rKIVI-A xc:c.�,� �j { rL ry�{.��Z.:G7tli i•.�i , ii./p

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-119-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you fur SCICCtion to this commission/committee?

2. 3.

I low long have you resided in Yucaipa?,Z
REFERENCES:

Completed applications should be returned to the City C►erles Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: ✓') �E'� �� , Date:

ZAGENERAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMITrEEMCitizen Service Application.doc -120-

CITY OF YUCAIR&eived
WIN",All" 34272 YUCAIPA BOUL�L+i A� -lcair
YUCAIPA, CA 9239gOV 14 Ill»
(909) 797-2489

CITIZEN SERVICE

RECEIVED
(Name) 1-
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Address:

I -ionic
Phonc:

Email:

Occupation:

Educational Background:

Commission or Commitu
If you are applying to the ,
the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) J
I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Wily are you interested
s positioal?
�r c�
Ir

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-121-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committe/e?
14� Si��
7 �///
• .� 1.t t��i� /.. r�1,�1 .(� J `i �� y /v<'' � 11- -
fi..ow long have you resided in Yucaipa?
REFERENCES:
— �— '?, �1i SAC;-
_ � lr � � �. < 2.

Applicants arc advised that they may be requested to make information available regarding any J potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

S
Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORE GOIN` NFORMATI • NT IS TRUE AND CORRECT. �� ZSignature of Applicant: hate.

ZAGENERAL SERVICES - CITY CLERMCOUNCIL, COMMISSIONS, COAINIMEESICitizen Smice Apptication.doc -122-

PUBLIC ARTS

COMMITTEE
-123-

DocuSign Envelope ID: 29FO08BE-0434ABFE-A1FO-820FC34A9EE6 CITY 4F YUCAIPA City ipa
34272 YUCAIPA BOULEVARD DateSEP 9 1 ZUZZ—
YUCAIPA, CA 92399 By: �-
(909) 797-2489 Gener9fa5b11'viceS1
City Clerk s Departi i ient

Name of Applicant: DARYL. ANN BRYAN
First Middle Last
Address:

Number and Street City Zip Code
Home Work Cell Phone: —
Phone: Phone:

Email:

Occupation: Retired Teacher
Educational Background: Bachelor's Degree in Liberal Studics/Multiplc Subjects Teaching Credential Commission or Committee for which you are applying: Public Arts Committee If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

OoouSlpned by;
Applicant signature: rvarqb uggN
Why are you interested in this position?
I feel Art is extremely imporinnt to our community and can help express the vision of Yucaipa I have served on the Public Arts Community for two years and would be honored to do so again.

With Yucaipa changing and growing, Art can be a document of the history and future of Yucaipa's path.

Art has been a part of my life personally and professionally... and 1 feel my voice on the committee would be valuable.

I am a team player and feel that my contribution to Yucaipa would be appreciated.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL Vt'1LL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-124-

DocuSign Envelope ID: 29FO08BE-D434-4BFE-AIFO-820FC34A9EE6

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
j, I have actively participated as a member and chairperson on the Yucaipa Public Arts Committee from 2020 - present.

2. Art has always been an important part of my life professionally and personally. I feel I have a lot of experience, passion, and energy to add to the committee.
3, 1 am not afraid of change, but I appreciate the value of history. Yucaipa is changing and I feel Art is a way to embrace change gently, while still keeping Yucaipa's heart.

How long have you resided in Yucaipa? 13 years
REFERENCES:

1. Megan Wolfe

2. Mary Johnson
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTI1i Y THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

DoeuSipned by:

Signature of Applicant: �C{(, �J Date: 9/1/2022
EM...

Z:IGENERAL SERVICES - CITY CLERKICOUNCIL• COMMISSIONS, COMMITTEESICilizco Service Application.doc -125-

DocuSign Envelope ID: 29F0088E-D434-46FE-AlF0-820FC34A9EE6

DARYL BRYAN

OBJECTIVE
To be considered to serve on the
Yucaipa Public Arts Committee
SKILLS
• Currently hold a Multiple
Subject Teaching Credential,
with a Supplemental in Art and
English.
• Art Instructor of the Young
Artist's Academy (Children's
Art Classes) through the YPAC
• Art Instructor of the Elements
Class (Adult Art Classes)
through the YPAC
• Paint Nights through YPAC, as
well as Yucaipa's Festivals.

EXPERIENCE

TEACHER
1992-2018
Elementary Teacher for San Bernardino City Unified School District

EDUCATION
1992
California State University San Bernardino
Multiple Subject Teaching Credential
Supplemental Credential in Art and English
Bachelor's Degree in Liberal Studies

VOLUNTEER EXPERIENCE OR LEADERSHIP
• Volunteered many hours for Concerts and Performances at the Yucaipa Performing Arts Center.
• Implemented and taught Paint Night Fundraisers for Palm Avenue Elementary School.
• Past Board Member at VisionQuest
• Helped install Gallery Exhibitions at the YPAC Gallery • Served as Chairperson on Yucaipa's Public Arts Committee (2020-present)
-126-

CITY OF YUCAIPA city e ucaipa
Date:
34272 YUCAIPA BOULEVARD -
YUCAIPA, CA 92399 B�,.OV 0 3 2022
(909) 797-2489 c (Name)
CITIZEN SERVICE APPLICATI69erk's Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Address:
11omc
Phone:

Email:

First Last
Work Cell Phonc:

Phone:
`/y
Occultation: /17`7 /�' c•�- N'I. e c�� au /� . i,St-i fz4"cgt.� �., Educational Back round• ! SUY� 1.IA"/ � `� SJnI L_! 5 l g
Commission or Committee for which you are applying:

If you -au, to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa.Nlunicipal Code § 15.20.070, Subsection A (1)) I declare that I am neither 'are ident nor a park owner of a mobile_home p� r in the City of Yucaipa, that I have no financt117ntecest (as defined -by state law) in any mobilehome or mobilehome park and have no parenfs,c ildren, souse or siblings with any such interest.

Applicant signature:
/v1C-1111 •-
Why are you interested in this position?
L
7Lc�F S ai^
. _ `'� l•. hf.7/�n�/J/'. `t SS•/irol �ii / I••.•.J J`�/j V' %Jf� A _ it / Ulcyil$ra>t.nr'�"

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH
ASSIST THE CITY COUNCIL IN THEIR SELECTION.
/ -4,1 _ / -,—�
FEEL WILL 14y? g-
-127-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that tVould cfualiiy VOL] fir selection to this commission/committee?
/mil . �s i•�,,, �.,u t;�. �� %P�r � , �. �>: �, �%�9�� _. �• •T,�,�... %�"v� ,,,��.n 3 C:" Gcci�ii' e"tJ-'le/,7/

2. y�-- fiGi %.i� /Y�� ru.> .�% c[: �Y- 7 �J^� �'" %�'� •� , 1LLt1an«fLf—ke!-1 a�7%

3. c . v rr� �-, �� s.• Ul^ �? r� �ja� `s Et. r� �i7'
boa. TY u C'o ir� L:✓c�� ,5 Ci GY f,�-j? s f� ,t /�[ c�'t_S How long have you resided in Yucaipa? 13 -5-4S•eV7 r y
REFERENCES:

2. Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/properly and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INi+ORMATION IS TRUE AND CORRECT.

Signature of'Applicant: ! =/ =r��- Date:

ZAGENERAL SERVICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMITTEES\Citizen Service Application.doc -128-

DocuSign Envelope ID: 65FQ67DE-E485-4BC3-8219-58975DBADAB8 CITY OF YUCAIPA Received ` eive 'D
34272 YUCAIPA BOULEVARD CiY
YUCAIPA, CA 92399
(909) 797-2489 SEP (`
CITIZEN SERVICE APPLICATIQ��,`; e ;�� nPlod tmeni
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Kit H Satre
First Middle Last
Yucaipa 92399
Address: _
Number and Street City Zip Code
Home Work Cell Phone: -
Phone: Phone:

Email:

Occupational Therapist, Photographer
Occupation:

Educational Background: Master's degree
Commission or Committee for which you are applying: Public Arts If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

DocuSlaned by:

Applicant signature: G& R Sal'V�.
lreas�sf3z ...

Why are you interested in this position?
Passionate about promoting original art throughout our home community. Greatly encourage local residents to explore their artist talents and exposureldisplay of such.

Facilitating increased good quality art projects city wide.

Years of collaborating with local artists and their artworks.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-129-

DocuSign Envelope ID: 65FQ67DE-E485-48C3.8219-58975DBADA58

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Current president of the Vision Quest Art association in Yucaipa

2. Lifelong Photographer specializing in photographing wild life 3, dedication to promoting Local artists and art projects in your own community.

Flow long have you resided in Yucaipa?
REFERENCES:
1 Ray Casey City manager
2 Mical Madison professional water color artis.
36 Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

L�ii
cuStgned by:
�SPi t, 9/12/2022
Signature of Applicant: Dale:
r .cry
K1 GENERAI. SERVICES -CITY CLEWCOUNCIL, COMMISSIONS, COMMn-mmcitizen Service Applicatio:t.duc -130-

CITY OF YUCAIPA izt EiVYuc
UateG�ty of ucaii_ a
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 By:
(909) 797-2489 One
--General Services/
CITIZEN SERVICE APPLICATIONy Clerk's Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Conunittee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Lillian R Vasquez
Address:

Home
Phone:

Email:

First Middle Last
Yucaipa 92399
Number and Street City Zip Code
Work Cell Phone:

Phone:
occupation: Marketing/Communicaiton/Broadcast
Educational Background: AA Theatre; BA Liberal Arts; BA Communications Commission or Committee for which you are applying: Public Arts Commission If you are applying to the Mobilehome Rcnt Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilchome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I like the concept of beautification for the city. I enjoy putting on artshow and showing off the work of artists. Art gives a voice for some who might not otherwise have a voice.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WIIICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-131-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commiss ion/cominittee?
I. I have organized several art shows in my career.

2. 1 work each year to create calendars using the artwork of individuals with autism.
3- While I am not an artist I can bring another voice to the table as part of the committee.

How long have you resided in Yucaipa? Over 10 years
REFERENCES:

1. Ted Alejandre

2. Greg Bogh
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, Califomia 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFOR IMA.TION IS TRUE AND CORRECT. l 1
P 4 �
Signature of Applicant: y�9 ��, ', A- Date: 10/1/2022
ZAGENERAL SERVICES - CITY CLERMCOUNCIL, COMMISSIONS, COMMITTEESICitizen Service Application.doe -132-

TRAILS AND OPEN SPACE

COMMITTEE
-133-

DocuSign Envelope ID: EOD98DCA-E389-AC55-AEC5-04FDC5C82056 -911 CITY OF YUCAIPA
wiffl-tIll 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 GE
C ty Of YucalpD
Date:
0 8 262
(Name)
deral
Uty Clerk's Depilrtlrlent

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in fiill. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Kathryn A. Barton
First Middle
Address: ucaipa, CA 92399
NUtlll)CI- and Street City
Home Work
Phone: Phone:

Email:

Occupation: Retired
Cell Phone:

B.A., Communications, California State University, Fullerton Educational Background:

Last
Commission or Committee for which you are applying: Trails & Open Space Committee Zip Code ---
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

DocuSlgncd by;
Applicant signature: ba.yf ml
Why are you interested in this position?
It has been one of my great pleasures in retirement to serve on the Trails & Open Space Committee and I would like to be considered for re -appointment. Particularly gratifying has been the positive community reaction to the committee's monthly Take -a -Hike events that have introduced many community members to Yucaipa's spectacular multi -use trails.

Additionally, with the opening of the Wildwood Mountain Bike Trail, the city has solidified its reputation as a destination for off -road cyclists. I would be honored to continue my involvement with this committee.

ATTACK A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU PEEL WILL.

ASSIST THE CITY COUNCIL IN THEIIt SELECTION.
-134-

DocuSign Envelope ID: EOD98DCA-E389AC55-AEC5-04FDC5C82056

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/conunittec?

1. Extensive experience in grant writing, which I hope to put to work for the benefit of Yucaipa's multi -use trails.

2. Ongoing involvement in service, particularly with the Yucaipa Valley Conservancy and Supporters of Wildwood Canyon State Park.

3. Great love and appreciation for Yucaipa's trails and open space, dating back at least 20 years.

How long have you resided in Yucaipa?
REFERENCES:
7 years

1. Kristine Mohler, current co-chair, Trails & Open Space Committee z. Mike Bagg, current member, Trails & Open Space Committee Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

DocuSlgned by:

Signature of Applicant: r V' t?"r 6vu Date., 11/9/2022
Z,IGENERAL SERVICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMITTEES1Citimn Servicc Applicntion.doc -135-

DocuSign Envelope ID:EUD98DCA-E389-QC:i5-AEC5-OAFOG 5C82056 I{Amy BARTON
ucaipa, CA 92399
Cell:

Professional Employment:

Nov. 2020-present Special Assistant to the Senior Associate Dean, Medical Education School of Medicine, University of California, Riverside Duties include parttime writing and editing in preparation for re - accreditation.

June 2019-Oct. 2020 Fully retired
Aug. 2018-June 2019 Special Assistant to the Dean
School of Medicine, University of California, Riverside Oct. 2007-June 2018 Assistant Dean, Strategic Initiatives/Executive Director, Strategic Initiatives/Director, Communications
School of Medicine, University of California, Riverside Member of team launching California's first public medical school in more than 40 years. Served as trusted advisor to Dean and other leadership on communication issues and as project director for strategic initiatives. Played key role in strategic funds development and accreditation. Contributed to major medical school activities, including preparation of accreditation documents and recruitment of senior leadership.

April 2006-Oct. 2007 Director of Technology Collaboration, Office of Governmental and Community Relations, University of California, Riverside Coordinated private/public partnerships to expand academic and research opportunities for UCR. Assisted efforts to commercialize campus technologies. Directed completion of campus' first comprehensive economic impact analysis.

July 2003-April 2006 Director of Marketing and Research, College of Natural & Agricultural Sciences, University of California, Riverside
Provided leadership for and managed all aspects of the College's marketing efforts. Coordinated major interdisciplinary, multi - investigator grant proposals to federal funding agencies and private foundations. Assisted Dean and Associate Deans with strategic academic planning and operational documents.

Sept. 2004-Jan. 2005 Acting Executive Director of Media Relations, University of California, Riverside
On interim basis at 50% FTE, responsible for managing the Office of Marketing and Media Relations, comprised of nine communications -136-

DocuSign Envelope ID: EOD98DCA-E389-4C55-AEC5-04FDC5C82056 professionals in the Media Relations, Creative Design Services, University Internet Development and Video Production units.

Consulted with senior campus leadership on news media
communications involving sensitive and controversial matters. Acted as chief campus spokesperson.

Sept. 2001-July 2003 Grant Writer, Genomics Institute, University of California, Riverside Coordinated major interdisciplinary, multi -investigator and equipment grant proposals. Conceived and managed creative design of Institute website and printed materials. Assisted in planning and relocation of Core Instrumentation Facility. Provided high-level support to Directors of the Biotechnology Impacts Center and Center for Plant Cell Biology.

July 1995-Aug. 2001 Associate Director of University Relations, University of California, Riverside
Responsible for hands-on management of UCR's news media communications, consulting with the Director of University Relations.

In absence of the Director, served as chief campus spokesperson, including managing irnmediate campus response to the news media in events of emergencies or sensitive issues. Executed strategies to gain campus coverage in major national media. Drafted speeches and op-ed pieces for Chancellor, as requested.

June 1987-June 1995 Senior Public Information Representative, University of California, Riverside
Aug. 198 5-May 1987 Public Information Representative, University of California, Riverside 1981-1985 Staff Writer, Orange County Register
Technical Skills:

Computer Literacy Advanced skills in Microsoft Word, Outlook, PowerPoint; competence in Excel, Photoshop; and familiarity with Adobe Acrobat.

Proposal Preparation Extensive experience and proficiency in all aspects of grant proposal preparation and submission to federal agencies, private foundations and University of California research programs. Skills include: writing non -scientific aspects of project descriptions and abstracts; budget preparation; coordination of major interdisciplinary, multi -investigator proposals; and compliance with institutional policies and procedures relevant to proposal preparation.

Photography Proficient in digital still photography.

Education:

California State University, Fullerton Communications (Joarnalisrn) B.A. 1981 2 -137-

DocuSign Envelope ID: EOD980CA-�--3B9.4C55•AEC5-04FDC5C82056 Continuing Education:

University of California Business Officer Institute, 2011 Grantsmanship Training Program, The Grantsmanship Center, 2003 Professional Memberships:

Association of American Medical Colleges (past)
Council for the Advancement and Support of Education (past) CampusfUniversity Service:

UC Regents:

Seined as Staff Advisor to the Regents (UC Presidential appointment), 2012-14.

UCR Staff Assembly:

President (2005-06); Vice President -President Elect (2004-05); Communications Co -Chair (2003-04).

Council of UC Staff
Assemblies:

Junior Delegate (Riverside campus), 2004-05; Senior Delegate (Riverside campus), 2005-06.

UCR 2020:

Member, Community Engagement Subcommittee developing the community outreach and external relationships component of UCR's strategic plan.

Search Committees:

Served on a variety of search committee for midlevel management staff at UCR.

Volunteer Activities:

City of Yucaipa: Member, Trails & Open Space Committee
Non -Profit: Board Member, Friends of Wildvood Canyon State Park Board Member, Yucaipa Valley Conservance
UCR School of Medicine: Member, Community Advisory Board Chamber of Commerce: Active in Greater Riverside Chambers of Commerce; served as President of the Hunter Park Business Council 2009-10 and a portion of 2010-11.

City of Riverside: Member, Organizing Committee of the Riverside -Sendai 50" Anniversary Celebration, 2007.

Route Champion, Route 4: Home of Next -Century Health Care (one of 11 initiatives in the City of Riverside's strategic plan "Seizing Our Destiny: The Agenda for Riverside's Innovative Future," 2010-11, Community: Variety of ad hoc volunteer activities over the years, including with the YHS Mountain Bike Tearn and YIPS Cross Country Team.
3 -138-

DocuSlgn Envelope IQ: E3285A3A-CC7D-4A40-8013F-598FOC291516 CITY OF YUCAIPA.
a.:
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
CITIZEN SERVICE APPLICA7

RECEIVED
DRpceived
Ity Of ucaipa
By:

SEP WPM
I Services/
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Kandic Lynn Cansler
First Middle Last
Address:
ti'ucnipa 92399
Number and Street City Zip Code
I-Iome Work Cell Phone: -
Phonc: Phone:

Email:

Occupation: retired
Educational Background: high school, limited college
Commission or Committee for which you are applying: The Yucaipa Trails and openspace Committee If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
ooeusiQnea by:

Applicant signature: 6.kt, CaL4.,s( r
Why are you interested in this position?
I have been on this committee for several years and believe we arc doing a great service for the residents of Yucaipa and I would like to continue in the position I currently serve in.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-139-

DocuSign Envelope ID: E32B5A3A-CC7D-4A40-80BF-598FOC291516

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. current member of this committee

2. 1 work with wildlife which is a natural connection to our trails and openapace 3_ Have been a member of this community almost my entire life How long have you resided in Yucaipa? raised here
REFERENCES:
1 Kristine Mohler
2 Lenore Will
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

FZi,(,-sta
gned by:

Signature of Applicant; Date: 9/1/2022
ZAGENERAL SERVICES - CITY CLE•RKICOUNCIL, COMMISSIONS, COMNIITT EL•S\Citizcn Scrvicc Application.doc -140-

DocuSiyn Envelope 10: C5455FBC-724F-434C-8A66-2683BA40526F CITY OF YUCAIPA CRI %Caipa
Date:
34272 YUCAIPA BOULEVARD SEP 0 a 2022
CA 92399
YUCAIPA, By:

General
(909) 797-2489 Cit eral
Clerk's pepartMer:t

Name of Applicant: DeDe Chudy
First Middle Last
Address: Yucaipa 92399
Number and Street City Zip Code
Home Work Cell Phone:

Phone: Phone:
same same
Email:

Occupation: Rancher
Educational Background: Mt San Antonio AA degree Cal Poly Pomona BA Commission or Committee for which you are applying: Trails and Open Space If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Ooeu5lpned by:

Applicant signature:

Why are you interested in this position?
I have been serving here for several years and would like to continue.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL.

ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-141-

DocuSign Envelope ID: C5455FBC-724F-434C-BA66-2683BA40526F

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Knowing the trails

2. Concern about how our open space is being developed

3. Wanting to serve the community that I love.

How long have you resided in Yucaipa? 26 years
REFERENCES:

1. Ray Casey

2. Fermin Preciado
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Oocu Sig ned by.

Signature of Applicant: E-

ZAGENERAL
-142-

� CITY OF YUCAIPA
1, 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
RRCety> n
Date:

By:
(Name)

CITIZEN SERVICE APPLICATION
The Yucaipa City C011nCil is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Comnuttee. Plcase complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

KELLIE
First

LAROCCO
Middle Last
Address: E YUCAIPA 92399
Number and Street City Zip Code
1'I01-ri c Work
Phone: NIA Phone: N/A
Email:

Occupation: REGIONAL SALES COORDINATOR
Educational Background: SOME COLLEGE
Cell Phone:

Commission or Committee for which you are
applying: VECTOR CONTROL & TRAILS AND OPEN SPACE
If you are applying to the Nlobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings With anv such interest.

Applicant signature: K(. [..0 . ) r- Or-r e t'
Why are you interested in this position`?
I am a long time resident who is passionate about this city and it's history.

My Family raises our own fruits, vegetables and animals. We enjoy and utilize the trails and open space areas throughout our city. I feel hcnored to be considered for a position on these committees to be a voice for my community and an advocate for responsible stewardship of our lands.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-143-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would quality' you For selection to this commission/committee?
I- Collaboration

2. Communication
Passion/Self-aware
How long have you resided in Yucaipa? 45 years
REFF,RENCI S:

Chris Venable
Amanda Tullio
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their businessiproperty and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office. 34272 Yucaipa Boulevard.

Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORINIATION IS TRUE AND CORRECT.

Signature of Applicant: #;1_ i _t t. ��t i�c`!' C.r Date: 12/05/2022 litips1hucaipa.sharepoint.com/sitesiGeneralSen•tces;Shared Doe umentslGeneral Smiees_Cin• Cle&4-F CITY CLERK FILFSCOUNCIL.

CON] N,lISS IONS, comivirr,I-:ESiCidzen SMice Application.doc -144-

Received_
CITY OF YUCAIPA Ci#WWWI caip
Date:
34272 YUCAIPA BOULEVARD DEC 08 211M
YUCAIPA, CA 92399 By: ---
(Narnc)
(909) 797-2489 GeneLaL9jecvicE
City Clerk's Department

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist sand advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Leonard C LaRocco Jr
First ^—�-- Jr
-
First
Last
Address: Yucaipa 92399 _
Number and Street City Zip Code
11omc Work
Phone: . Phone:

Email:

Occupation: Manager
Educational Background: undergraduate
Cell Phone:

Commission or Committee for which you are
applying: Parks and Recreation & Trails and open space
If you are applying to the Mobilehomc Rent Review Commission, please initial helow pursuant to the City of Yucaipa Municipal Code $15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehomc park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehomc or mobilehomc park and ha c no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why arc you interested in this posit'
am an avid mountain biker whom enjoys our local trails and parks. _ Being a long term resident I want to be sure the trails/parks will be protected and used responsibly
AwAdi A RESUME MNDIOR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ,%SSISTTHE CITY COUNCIL IN THEIR SELECTION.
-145-

CITIZEN SERVICE APPLICATION

PACE TWO
What do you consider to.be three (3) major assets that would qualify you for selection to this commission/committee?
1 • Analytical and detailed driven

2. Team player

3. Punctual and dependable
How long have you resided in Yucaipa?
REFERENCES:
47 years
l Chris Venable
Heather Van Grouw
Applicants are advised that they may he requested to make infonnation available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisi6ns taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOIVG I
Si,nature of Applicant'
2VIATT N IS TRUE AND CORRECT.

J '
V ; Date:Z-
hops.11yueaipa.sharepoinl,conJsitcVGcncralServicteShared Documews (icrwril Scrvirec City Clcrk,'1r CITY CLERK FILMCOUNCIL.

COMMISSIONS. COMN111`MES.d iiinn Service ,application do:
-146-

ILL
CITY OF YUCAIPA t�ceivt D
Received
ft� 34272 YUCAIPA BOULEVARD C t°y°of \ )
YUCAIPA, CA 92399 By: ,
(909) 797-2489 Nov Hz/�
CITIZEN SERVICE APPLICA;fOR',a' services/ ^;
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in frill. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

First
Address:

Middle Last
City
Home Work Cell Phone:

Phone:Phone: -6,.1
Email:
—NEEMIPMm—
Occupation: 1 -t ram, . I rt,�l; Jor.ues_
Zip Code
Educational Background:

Commission or Committee for which you are applying: _�
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that 1 have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
4 � �'�i174G�/� tee' ! / / . ( Ceci 11/ca41 110.&I' =

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FELL WILL ,ASSIST THE CITY COUNCIL IN THEIR SCL.ECTION.,
-147-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

2. 3.

How long have you resided in Yucaipa? b �Z + P".-r-�
REFERENCES:

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

J /
Signature of Applicant:-//li"E' Datc: C�-,5 `%-
ZAGENCRAL SERVICES - CITY CLEWCOUNCIL. COMMISSIONS, COMMr T1313 Citizen Service Application-doc

11JL tj CITY OF YUCAIPA C
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 Ger
of Yt�dp�j5��°
Date
a 012022
. _ (Flame)
City Clerk's Department

Address:

Home
Phone:

Iva
First k • Middle Last
Work
Phone:

Email:

Occupation:

Educational Background:

Cell Ph
Commission or Committee for which you are applying: \ V-LVS,— iZ
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
1 Applicant signature:

Why are you interested in this position?
ko
ATTACH A Ri, SUME A) IOR ADDITIONAL INFORMATION WITICI3 OU FELL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-149-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
How long have you resided in Yucaipa?
REFERENCES:

1. 2.
l
IJ
w-at��
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with. the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 54272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE F'OREGOI INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: Date: I-20 'G2
t
Z:IGENE•RAL SERVICES -CITY CLERKICOUNCIL, COMMISSIONS, COMMITrEESICitizen Senice Applieation.doc -150-

DocuSign Envelope ID: GOC24022-C456-4295-96E1-A55B5721A794 CITY OF YUCAIPAff`°Yla��
Date:
34272 YUCAIPA BOULEVARD NO 0
YUCAIPA, CA 92399 11y:
(909) 797-2489 Ger ae? S S�
MY Clerk's Partment

Name of Applicant: Robert Richmond
First Middle
Address:

Number and Street City
Home
Phone:

Email:
nCCllllatlOn: Retired engineer
Work
Phone:

Educational Background: Electrical Engineering
Last
Zip Code
Cell Phone: -
Commission or Committee for which you are applying: Trails and Open Space Committee If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
oocusiynea by:

Applicant signature: cl�
KC66 .W57FSFV32U7C ...

Why are you interested in this position?
I care about Yucaipa's trails and open spaces, and I'm qualified to contribute in this area, I regularly hike the City trails.

ATTACH: A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-151-

DocuSign Envelope ID: 60C24022-C456-4295-96E1-A55B5721A794

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
1, 1 am a Board member of the Crafton Hills Open Space Conservancy. I act as a liaison with that committee.

2. [have been a member of the Trails and Open Space Committee for the past six years.

I have made many contributions to the efforts of the committee.

3. 1 manage the Adopt -A -Trail program for the committee.

I wrote a book - "The Yucaipa City Trail Guide" and have mapped all the City trails (available online).

How long have you resided in Yucaipa? Sixteen years
REFERENCES:

I. Fermin Preciado
2 Scott Washburn
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing; dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

O-ocuSignedby;
Signature of Applicant: lz6b KtAov'J Date: 11/2/2022
Lt1GENERAL SERVICES - CITY CLERKTOUNCIL, COMMISSIONS, COMMITTEES1Citizcri Scrvicc ApplicationAoc -152-

DocuSign Envelope ID: 6B86CABO-46764C36-813C-E75BBA95CF5A JL IL CITY OF YUCAIPA cit of Yucaipe
34272 YUCAIPA BOULEVARD Date:

S te 2022
YUCAIPA, CA 92399 �y
(Name)
(909) 797-2489 Gen ral Sarviroc
City Clerk's Department

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Comnlission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant:

Patrick Leigh Smith
First
Address: ucaipa, CA 92399
Number and Street
110111e Work
Phone: Phone:

Einait:
'1'cachcr
Occupatloll:

Middlc
City
Last
Zip Code
Cell Phone: -
Educational Background: College Graduate - BA, CA Clear Teaching Credential, MA Commission or Committee for which you are applying: Trails and Open Space If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

OocuSipned by:

Applicant signature: FP SM&
Why are you interested in this position?
i' was born and raised in Yucaipa and have spend the majority of my adult life here. 1 have enjoyed outdoor activities like hiking, running, and mountain biking and feel fortunate that our community offers so many opportunities to enjoy these pastimes. As a member of the Trails and open Space Committee I have a unique opportunity to maintain and expand our trail systems and open spaces for all to enjoy.
.ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WIIICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-153-

DocuSign Envelope ID: 6886CAB0-467B4C36-813C-E75BBA95CF5A

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this Commission/committce?
1, 1 have held service and leadership positions associated with the teaching profession throughout my 26 years of employment including service at the state level of the California Teachers Association. 2, [have experience functioning in formal meetings and am familiar with Roberts Rules. 3, 1 was born and raised in this community. I have spent the majority of my adult lice as resident and teacher in this community, 1 believe it is my responsibility to serve the community in which I reside.

How long have you resided in Yucaipa?
REFERENCES:
51 years

1. Mike Bagg - Member of the Yucaipa Trails and Open Space Comittee

2. Gary Smith - Long-time Yucaipa Resident
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property anti/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FORE, GOING INFORMATION IS TRUE AND CORRECT. oocu5lgned by,
Signature of Applicant: i& �,,t Date: 9/1/2022
E_2__1pdM5Tr5Mr19s 11, _
Z:IGENE•RAL SERVICES • CITY CLERKICOUNCIL, CONINIISSIONS, COMMITTEES1Citizcn Scrvicc Application,doc -154-

ft"MCITY OF YUCAIPA e``"'1D
of Yucaipl_i
Uata
34272 YUCAIPA BOULEVARD )
YUCAIPA, CA 92399 a;`IOV
(909) 797-2489 (Ttumc) !.r
''Irrk's Department

CITIZEN SERVICE APPLICATION -
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed With the City Clerk.

Name of Applicant:

Address:

Homc
Phone:

Ian M Tillen
First
Middle Last
Number and Street City Zip Code
Work
Phone:

Cell Phone:

Email:

Occupation: Material Operations Senior Specialist - SCE Educational Background: Some Colle
Commission or Committee for which you are
applying:
/ Trade
Trails and Open Space
If you are applying to the Mobilchome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20,070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
am interested in joining the Trails committee because I love Yucaipa, and enjoy its natural resources. I like the new wildwood mountainbike trail addition, and am excited to see what else can be done for the community.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-155-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) ma.jor assets that would qualify you for selection to this commission/committee?
I My construction background gives me a realistic perspective on proposed development, possible issues, and unique insight. '- 1 am a vested community member, who values what Yucaipa has to offer, and a keen interest in the direction it will go.

3. My general disposition is measured, and thought out. Friends and family would say I'm detail oriented, and do not cut corners.

I -low long have you resided in Yucaipa? 24 Years
REFERENCES:

I. Jason Ross -
2, Brandy Gomez, CLPF, NCG -
Applicants arc advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard.

Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT. i
Signature of Applicant: i� _ Date: 0 1 Zf -2z-
Mips /hucaipa sharcpoini eonVsi["?GeneraIScrNicc0hared rh)cumcnWGcncral Smices _Crg C1crkl,R, CI I CLERK FILBICUIINCII..

C041MMIONS, CO-NI\II H I LS/Cuiicn Scnicc Application doc —156—

All

CITY OF YUCAIPA
WAN City of Yucaipa
111 ;t#34272 YUCAIPA BOULEVARD Dam '
YUCAIPA, CA 92399 By: OCT 17 20?_2
(909) 797-2489 1
(Name)
CITIZEN SERVICE APPLICATId&' C'`rl<'s C�ohartment
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: PAC r' Lobe- 4" %-i SJo -J"
First Middle Last
Address: YL,-cc, "n qu C1
Number and Street City Zip Code
I lone
Phone:

E-mail:

Work
Phone:

Occupation: ,Se « F16y C,
Educational Background:

Cell Phone:

Commission or Committee for which you are applying: Ore v\ Shoe �rG,1 S Cvn,,,, ,44e C If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (l)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
�o� r'- ShD �QJ �tl..r.✓l Iacds Y-/ ",.L & I r �4 �
Like Y �� ewe- `Wed.L!.l
� I�g wi G wi o� �s a` �GYd Gd- 7"Le 7 `JO Yy, oL-P% •a 1 e\ r Le kra ltile't"j-a 61 �itivF— -}-vu (IS �S rv�p.4e-ftoL is ' ✓c f ecr„ �H 1�✓ewe✓ we koc/e %l,-

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-157-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
t. _T le-8 r idri f )%iou t1, j-ke bre we�1 AaI�� U�Je d-lti e.. (�trGt�1 1,o-4./'t!! e 4'1n--ei A l-ee��

2. o-,� t,-d?Ir 4—Fhee OA lh^ct.(n LC --nth
A-15d. +f e- E- b,ke is-rkc%j 4-rr- it quiet &n,
�. we a 4-o c cl h"b ✓c. 4-1,ca , It to VUca I a-
ttih �trr�-a,� 4-W- f''1 ^ems a�
pla^p �6 . I've, he-(? R o )i --tee c-o 44-c C ' Fv,, �.e j a sd- y-ec.r .

How long; have you resided in Yucaipa? L. eve. 0—y- c-t• A,)4-5 i- S'p"'ea 8r� REFERENCES:

2. k� •� �1 l3- �-�
Applicants are advised that they may be requested to make information available regarding; any potential conflict of interest arising; from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard.

Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: pate:
4*13NERAL SURVICI 's - CITY CLERKTOUNCIL. COMMISSIONS. COMMIT EESTitizen Service Application.doc -158-

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 G
City o Kuca pa
Date:

Bpv 10 2022
(Name)
Citv Clerk's Department

Name of Applicant: Kathy J Utley
First Middle Last
Address: Yucaipa 92399
Number and Street City _ Zip Code
Home
Phone:

Email:

Occupation: retired
Work
Phone:

Educational Background: K-12 SB Valley Junior College
Cell Phone:

Commission or Committee for which you are applying: Trails and Open Space If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that l have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
I have been on this committee for over 20 years. I still feel I have a lot to offer and would be honored to continue serving.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-159-

CITIZEN SERVICF APPLICATION let
What do }-Ou consider to be 11irce maJor assets that would qualify )uu I'Lor selection to this co n i m i ss iori!co n im itt cc?
k
77'e
!Ina1011�g have you rcmued in YLMlip.l? z,
.51
R E rl--" R I -.'N.'C E ...........
7 2.

Applicants are advi.-wd that they rll-ly 110 MJLIC�Wd to make information available regardin aft Fx)wmial conflict of' interest ari.11in-, 11`0111 111cir hu%ineSsiprofvrtN andfor investments with the Ci of Yucaipa or where the decisions taken by Ow Ci(y of Yucaipa may influence that bust WMAW
Compictcd applic6tiC o'ns-1 Alould be retu d to t ic OClerk's Mce 34272 Yucaipa Bouleva N
Yocaipa, California 923997 prior to a11YL CloSilli, (InjeS established.

I INFORNIATION IS TRUE AND, i
Signature of Applicant:

OLNEP.M.SERW!
A,
Date:
y� ■

�""' I "# f '. CITY OF YUCAIPA l'lrQ'4-1l&k1
34272 YUCAIPA BOULEVARD Ddt itY Of YuCai
YUCAIPA, CA 92399 By. N9--�D�
(909) 797-2489 1
Gvl ier eji �ervices/ '
CITIZEN SERVICE APPLICAT16N C►C ^""-~' °ehal•imCni
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: /xa5
First Middle Last
Address: � s n'?,Q 3 T-T
ree City jJ` Zip Code
Home Work
Phone: Phone:

Email:

Cell Phone:

Occupation: —f �ll_CP I S �rp_c�t--� , 9v''
Educational Background: _ 3.,5d ih�1��v,Qi /n 1, , ;-1a4-,- 0n0,orJv ✓��v, Commission or Committee for wlvcll you are applying: r�,� � lf- Q If you are applying to the Mobilehome Rent Review Commission plea-se%uutial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?
apu �, r rQ be at"+p
"

ATTACK A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU KEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-161-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. 2,
3,
v
�T- h Ce Oe- e I %0 11-)rA -ed 44 -J1A � 1rt {�2 rvt 1 f I /;L t� How long have you resided in Yucaipa?
REFERENCES:
2,
tena
rn#,4fec
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY TIiAT T1 E FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant:, Date:��1=
Z:\GENEI AL SLUICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMITTEL•STitizen Service Applicntion.dac -162-

VECTOR CONTROL

COMMITTEE
-163-

CITY OF YUCAIPA
W 5 AR
IN
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489
RECEI VE.n
Date:

By:
(Name)

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to sere on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed Nvith the City Clerk.

Name of Applicant:

KELLIE
First

LAROCCO
Middle Last
Address: E YUCAIPA 92399
Number and Street City Zip Code
1-I0111e Work
Phone: N/A Phone: N/A
Email:

Occupation: REGIONAL SALES COORDINATOR
Educational Backgromld: SOME COLLEGE
Cell Phone:

Commission or Committee for which you are
applying: VECTOR CONTROL & TRAILS AND OPEN SPACE
If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code 515.20.070. Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, spouse or siblings with any such interest.

J
Applicant signature: C.- e Z
Why are you interested in this position?
I am a long time resident who is passionate about this city and it's history.

My family raises our own fruits, vegetables and animals. We enjoy and utilize the trails and open space areas throughout our city. I feel honored to be considered for a position on these committees to be a voice for my community and an advocate for responsible stewardship of our lands.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-164-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
I- Collaboration

2. Communication
3- Passion/Self-aware
I-Iow long have you resided in Yucaipa? 45 years
REFERENCES:
l Chris Venable
Amanda Tullio
Applicants are advised that they may be requested to make information available regarding any potential conflict of interest arising from their businesslproperty and/or investments with the City of Yucaipa or where the decisions taken by the Cite of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office. 34272 Yucaipa Boulevard.

Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Si pature of Applicant: Date: 12/05I2022
1•,ttps:l/yucaipa.sharcpoint. COWS ilesiCiencralSeryice sishared Documents/General Rrvices_City Clcrk14'i CITY CLERK FILFSCOUNCIL.

CO\ImissioN,s. co\INlfr'rEGS/Citizen Service Applicatkm.doe -165-

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399
(909) 797-2489 Citi,
Heceivecl
COof YUCaI a

RECEIVED
oNOV 2 8 2022
_ (u6mc'j
rtrer

CITIZEN SERVICE APPLICATION
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in frill. The applications should be typed or clearly printed and filed with the City Clerk. T
Name of Applicant: ✓ �/� /� ``` L)
First Middle Last
Address: %rItI4. P-11 !9d -3
Number anct StreetCity Zip Code
Home Work Cell Phone:

Phone: Phone:

Email:

Occupation: Re
Educational Background: s f�•� 4 C j ��c ��c�-�
Commission or Committee for which you are applying: t/�c� Lew r—n�f'n/<t"�Jz o�a.✓rJ�v//, If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) 1 declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature: G'/��G�•`lw��
Why are you interested in this position?
&,a-71- • 1V JN1 !/ t?. ^�- y'/ [/ C vow C',rc ' /F'K- C. G 7 .- / e v' 1 1^
a

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-166-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
. ! c""? _j1.4 rc. t!. ,4,,l y- G�`'C.'��'%• �GCL1'h f'

3. %�(�7�/•ze?C�? {i '/4^n c' : ��/ �' �' l,i -t"�c .. �C1�;.2c 1d.1j" n -r 1 f
How long have you resided in Yucaipa? /-j J— yr`-
REFERENCES:

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of'Al)plicant: v�,��LC-C��c i Date:

Z:IGENERAL SERVICES - CITY CLERK%COUNCII., COMMISSIONS, COMMITi'EES\Citizen Service Applicotion.doc -167-

YUCAIPA VALLEY WINE

COUNTRY PLANNING

COMMITTEE
168_

DocuSign Envelope ID: 8F09855F-C9144526-A577-9D17744F4843 F' CITY OF YUCAIPA F eceiErvED
34272 YUCAIPA BOULEVARD City nitc(ucaipa
YUCAIPA, CA 92399 p yo 5 —
(909) 797-2489
General Services/
CITIZEN SERVICE APPLICAW—ONs Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Cominission or Committee. Please complete this application for appointment in full. The applications should be typed or clearly printed and filed with the City Clerk.

Namc of Applicant:

Address:

Home
Phone:

Email:

James A. (Tony) Matlock
First
Number and Street
Work
Phone:

Middle Last
City Zip Code
Cell Phone: -
Wine Maker/ CFO Wildwood Oak Winery. Retired Business Management Occupation:

B.S. Engineering "Electronics"
Educational Background:

Commission or Committee for which you are applying: American Viticulture Area Planning Committee If you are applying to the Mobileliome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
oeu5lpned by:

Applicant signature: rja"jw's Aut(,6&-
Why are you interested in this position?
Have been a resident for over 60 years, been into;ved with this committee since inception. Looking to balance development and maintain are agricultural heritage for this community .ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN TIIEIR SELECTION.
-169-

DocuSlgn Envelope ID: 8Fo9855F-C914-4526-A577-9D17744F4B43

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. Process oriented and have lead teams in problem solving and process improvement

2. Currently in wine business as owner of a small boutique winery

3. Background in business turnarounds wher getting the stakeholders aligned and to agree on actions needed How long have you resided in Yucaipa?
REFERENCES:

1. Ben Mozzafari
2: David Avila
Over 60 years. Graduate of the Yucaipa School System 1973 Applicants are advised that they may be requested to hake information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORIMATION IS TRUE AND CORRECT.

Docu5tgned�b�y:

Signature of Applicant:
jcu%trs i iiCb Date: 10/5/2022
Z:IGENERAL SERVICES - CITY CLERMCOUNCIL, COMMISSIONS, COMMITTFMChizcn Scrvicc Application.doc -170-

Received
CItu gf Y,.._..1;_,
CITY OF YUCAIPA `�
t 34272 YUCAIPA BOULEVARD
YUCAIPA, CA 92399 Gene 11M:Se iwjjr,
(909) 797-2489 City Cle '

Home
Phone:

Email:

Occupation:
k.ny
Work Cell Phon
Phone:
�� -�'�r��2-
Zip Code
Educational Background:]
Commission or Committee for which you are applying: 1 ctP, n, t C.

If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position? `l
L (�)C �-

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-171-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?

1. 2.

3. How long have you resided in Yucaipa? -
REFERENCES:

1. 2.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Applicant: Date:

ZAGENERAL SERVICES , CrrY CLERK%COUNCIL, COMMISSIONS. COMMITTEES1Cilizcn ScMcc Applicatiun.doc -172-

DocuSiyn Envelope I0:44DCF43F-948,1-4C74-9ABD-Df79Ao99E1B8 CITY OF YUCAIPA RecelvecNED
34272 YUCAIPA BOULEVARD ci P4` Yam-,--
~ YUCAIPA, CA 92399 �v: � �—
(909) 797-2489
General S�mvic€b�
CITIZEN SERVICE APPLICAT1O=� �,'..'_'ot)artment
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. Tine applications should be typed or clearly printed and filed with the City Clerk.

Name of Applicant: Cesar Roldan
First Middle Last
Address: Yucaipa CA 92399
Number and Street City Zip Code
Home Work Cell Phone: -
I'hone: Phone:

Ismail:

Occupation: Realtor and Wine Grape Grower (viticulturist) Educational Background: BS in Business Admin, Entrepreneurship & Marketing Commission or Committee for which you are applying: Phianing-Commissitm, Yucaipa Wine Country PC If you are applying to the Mobilehome Rent Review Commission, please initial below pursuant to the City of Yucaipa. Municipal Code § 15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.
cuS�aned 6y:

Applicant signature: F�Sar FbU�
Why are you interested in this position?
I am interested in these positions because I can bring a unique contribution as Family man, business owner and minister.

My wife and I fell in love with this town and community and feel the responsibility to contribute to the beauty, growth, and thrive of it.

ATTACH A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEIR SELECTION.
-173-

OocuSign Envelope 10: 44DGF43F-9484-4C76-9A8D-Di 79A099ElB8

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection, to this commission/committee?

1. 1 have learned and developed the ability to work hard and complete tasks at hand.

2. 1 research in order to be informed and educated before making decisions.

3. Asa business person I am a problem solver and have the ability to see beyond the immediate and come up with win -win solutions.

How long have 3,ou resided in Yucaipa? 4 years
REFERENCES:

1. Bobby Duncan
2 Ray and Donna Snodgrass
Applicants are advised that they may be requested to mare information available regarding any potential conflict of interest arising from their business/property and/or investments with the City of Yucaipa or where the decisions taken by the City of Yucaipa may influence that business or affiliation.

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TREE ANT) CORRECT.

F�S,,,
cuftncd by:

Signature of Applicant:
w Date: 11/10/2022
J ...

Z:IGENERAL SERVICES - CITY CLERKICOUNCIL, COMMISSIONS, COMMITTEES\Citizcn Service Application.doc -174-

CITY OF YUCAIPA
34272 YUCAIPA BOULEVARD Cil
YUCAIPA, CA 92399
(909) 797-2489
Gen

CITIZEN SERVICE APPLIC
eceAT"
11 Services/
Department
The Yucaipa City Council is seeking citizens to serve on duly constituted City Commissions and Committees which have been established to assist and advise the City Council on specific matters for consideration which have been assigned to the respective Commission or Committee. Please complete this application for appointment in full. Tile applications should be typed or clearly printed and .filed with the City Clerk.

Name of Applicant: /- l C�%�% �. Q'7
First Middle Last
Address:

Home
Phone:

Email:

Occupation:

Educational Background:

Commission or Committee for which you are applying: 21KII If you are applying to the Mobilehome Rent Review Commission, please initial below pursuar►t to the City of Yucaipa Municipal Code §15.20.070, Subsection A (1)) I declare that I am neither a resident nor a park owner of a mobilehome park in the City of Yucaipa, that I have no financial interest (as defined by state law) in any mobilehome or mobilehome park and have no parents, children, souse or siblings with any such interest.

Applicant signature:

Why are you interested in this position?

ATTACK A RESUME AND/OR ADDITIONAL INFORMATION WHICH YOU FEEL WILL ASSIST THE CITY COUNCIL IN THEM SELECTION.
-175-

CITIZEN SERVICE APPLICATION

PAGE TWO
What do you consider to be three (3) major assets that would qualify you for selection to this commission/committee?
PM
v
How long have you resided in aipa?
REFERENCES:

Completed applications should be returned to the City Clerk's Office, 34272 Yucaipa Boulevard, Yucaipa, California 92399, prior to any closing dates established.

I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

Signature of Appticant: �C�/ Date: It .2v_4z
ZAGENERAL SERVICES - CITY CLEWCOUNCIL, COMMISSIONS, COMMrI-TEES\Citizen Service Application.doc -176-

Yucaipa City CouncilDecember 12, 2022

Yucaipa City Council
December 12, 2022