Fillable Application for Temporary Interim Appointment to the Board (Mt. San Antonio College)

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Application for Temporary Interim Appointment to the Board (Mt. San Antonio College)

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Applications must be received via mail or personal delivery no later than 4:00 p.m. on
Wednesday, December 4, by the Mt. San Antonio College President’s Office located in
Founders Hall, 1100 N. Grand Ave., Walnut, CA 91789
Application for Temporary Interim Appointment to the Board of Trustees
Trustee Area 5
APPLICANT INFORMATION
Name:
Date:
Address:
State:
Zip:
Home Phone:
Business Phone:
Email Address:
Occupation:
Company/Organization:
Business Address:
State:
Zip:
I am related to a current employee of the District. If yes, list name of employee and your
relationship. Yes No
Name:
Relationship:
SUPPLEMENTAL DOCUMENTS
Applicant must have the following materials included and submitted to the President’s
Office no later than Wednesday, December 4, 2019, at 4:00 p.m.
• A letter of interest addressed to the Board President, Mr. Robert Hidalgo.
• A detailed resume including education, employment experience, public and
community service experience, and leadership experience.
• A completed Application for Appointment to the Board of Trustees.
DISCLAIMER AND SIGNATURE
I understand that I may not be an employee of the District to serve as a member of the
Board. I certify that I meet all eligibility requirements (Note: To be eligible, an individual
must be at least 18 years old; a resident of Trustee Area 5; a registered voter; and not
disqualified from holding civil office by the Constitution or any law of the state).
Signature:
Date:
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Application for Temporary Interim Appointment to the Board (Mt. San Antonio College)

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Completed 25 July 2020

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