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2. I'd like to serve on:*

   1. Homeless Commission
   2. Planning Commission
   3. Environmental Commission
   4. Art and History Commission
   5. Parks and Recreation Commission
   6. Neighborhood Improvement Commission
   7. Community Development Advisory Committee
   8. Commission on Jobs, Opportunities & Businesses in Seaside
   9. Youth Commission
   10. Community Safety Advisory Committee
4. Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Alternate Phone Number
16. Please list your background, education, experience, and special skills:*
18. Are you willing to file Statements of Economic Interest (Form 700)?*

    1. Yes
    2. No
20. Are you able to attend meetings during business hours? (Most Boards and Commissions meet after 5 pm)*

    1. Yes
    2. No
22. Comments:
24. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
26. Electronic Signature*
27. Date*
    Date
29. Dear Applicant: As an employer with an Affirmative Action Program, we comply with Federal and State government record keeping, reports and other legal requirements. The completion of this data is voluntary and in no way affects your application to participate on any City Board, Commission or Committee. All data is kept in a separate confidential file by the Affirmative Action Office.
31. Name
33. Ethnic Origin

    1. American Indian or Alaskan Native
    2. Asian or Pacific Islander (including Asian Indian)
    3. Black

    1. Filipino
    2. Hispanic
    3. White
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field