COMMISSION/COMMITTEE DESIRED: ______________________________________________
NAME: _________________________________________________________________________
ADDRESS: _____________________________________________________________________
HOME PHONE: ________________________ BUSINESS PHONE: _______________________
OCCUPATION: __________________________________________________________________
Are there any evenings you could not meet? Yes ______ No ______
If so, please list:
Why are you interested in this position? ________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
What do you consider to be your major qualifications? _____________________________________
________________________________________________________________________________
________________________________________________________________________________
REFERENCES: 1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
Please attach a written statement containing any additional information you feel would be helpful to
the City Council.
APPLICATION FOR COMMISSION/COMMITTEE
COMPLETE AND SUBMIT TO CITY CLERK’S OFFICE:
21810 Copley Drive, Diamond Bar, CA 91765
or cityclerk@diamondbarca.gov