INSTRUCTIONS:
A separate application is required for each appointive position for which you apply. Applications should be filled
out completely so that the City Council may fully evaluate your qualifications. Once submitted, this application is a
public document and is open for inspection and copying. Return your completed application to: CITY CLERK'S
OFFICE, City of Yorba Linda, 4845 Casa Loma Ave, Yorba Linda CA 92886.
As a public agency, the City is bound by the provisions of the California Public Records Act (Government Code
Section 6250, et seq.). Applicants are advised that information they furnish may be considered a public record and
accordingly may be released to the public through a Public Records Act request.
As part of the selection process, applicants will be interviewed by the City Council in a public meeting which will be
televised.
NAME OF COMMISSION YOU ARE APPLYING FOR
FULL NAME PHONE
FIRST LAST
RESIDENCE ADDRESS EMAIL
CITY STATE ZIP NUMBER OF YEARS RESIDING IN CITY?
HAVE YOU SERVED ON A COMMISSION, BOARD OR
COMMITTEE FOR ANY CITY?
NO YES
ELIGIBLE TO REGISTER TO VOTE IN CITY?
A P P L I C A N T I N F O R M A T I ON
M.I.
IF YES, PROVIDE THE NAME OF THE APPOINTIVE POSITION & DATES SERVED
NO YES
PLANNING COMMISSION TRAFFIC COMMISSIONPARKS & RECREATION COMMISSIONLIBRARY COMMISSION
NAME AND LOCATION OF COLLEGES/UNIVERSITIES ATTENDED MAJOR DEGREE
E D U C A T I O N I N F O R M A T I O N
APPLICATION FOR APPOINTIVE POSITION
