Fill - Free fillable CITY OF SANTA BARBARA ADVISORY GROUP MEMBERSHIP APPLICATION (City of Santa Barbara) PDF form

Form 13, Application for Appointment Page 1

CITY OF SANTA BARBARA

ADVISORY GROUP MEMBERSHIP APPLICATION

Return Application to:

City Clerk’s Office, P.O. Box 1990, Santa Barbara, CA 93102-1990;

Fax to: 805-897-2623; or

E-Mail to:

CityAdvisoryGroupApplications@SantaBarbaraCa.gov

Completed applications are considered public records

per Government code §6252

Date Received

(City Clerk’s Office Use)

Name of the advisory group you are applying for:

Category/Categories (if applicable):

NOTE: A separate application must be submitted for each advisory group. If you have applied for appointment

to more than one advisory group, list all of them in order of preference:

1. 2. 3.

Are you a qualified elector* of the City? Yes No

* A United States citizen, 18 years of age or older, and living within the City limits of the City of Santa Barbara.

YOUTH APPLICANTS ONLY

Neighborhood Advisory Council Applicant: Are you age 16 or 17? Yes No

Parks & Recreation Commission Applicant: Are you age 16 or 17, and a United States citizen? Yes No

Santa Barbara Youth Council Applicant: Are you age 13 to 19? Yes No Date of Birth ________________

Which school do you attend? _____________________________________________________________________

APPLICANT INFORMATION

Name:

Residential Address:

Mailing Address (if different):

Telephone:

Fax:

E-Mail:

NOTE: All correspondence will be sent via e-mail (or U.S. mail when e-mail address is not provided).

EMPLOYMENT INFORMATION

Current Employer:

Employer address:

Telephone:

Fax:

E-Mail:

Are you a full-time paid officer or employee of City Government? Yes No

Select one from the drop down menu.

Form 13, Application for Appointment (8/27/2012) Page 2

EXPERIENCE/BACKGROUND

(Only one additional page of information may be attached to this application.)

Education:

Present Occupation:

Memberships in Organizations/School Clubs/Off-campus groups:

Reasons why you believe you should be appointed to this group:

Have you attended meeting(s) of the group for which you are applying: Yes No

Have you served on this group or any City Advisory Group before? Yes No

If so, please list group(s) and dates served:

STATEMENT OF ECONOMIC INTERESTS

I agree to submit Statements of Economic Interests* in a timely manner, if required, for the group to which I am

appointed. Initials:

_______

* Additional information regarding Statements of Economic Interests (Form 700) may be obtained by selecting “Conflict of

Interest” and “Form 700” on the home page of the following web site:

www.fppc.ca.gov.

SIGNATURE

I have read and signed the attached resolution adopting the City’s Nondiscrimination Policy and the Excellence in Customer

Service Code of Conduct; and, if appointed, will follow them in the conduct of my duties.

Signature: ______________________________________________________________________________________

FOR CITY CLERK’S OFFICE USE ONLY

Confirmation Sent

Date distributed to Council:__________________________

Applicant Database Updated

Date Interviewed:__________________________________

Interview Reminder Sent ; Date: _________________

Member Database Updated

Date Appointed:____________________

Term Expires:______________________

Form 13, Application for Appointment (8/27/2012) Page 3

RESOLUTION NO. 93-134

RESOLUTION OF THE COUNCIL OF THE CITY OF SANTA

BARBARA ADOPTING A CITYWIDE NONDISCRIMINATION

POLICY

WHEREAS, the City of Santa Barbara has had a long standing commitment to

nondiscrimination as evidenced by its practices and policies that have existed in various forms

since the early 1970's;

WHEREAS, the City of Santa Barbara receives Federal financial assistance which prohibits

discrimination;

WHEREAS, the City's Affirmative Action Program provides for nondiscrimination related to City

employment or other personnel actions;

WHEREAS, the City's Purchasing Office policies and Municipal Code 9.126 provide for

nondiscrimination related to the award of all contracts and purchase orders and by the

contractors and vendors providing services and materials;

WHEREAS, the City's Human Resources Division employee recruitment policies mandate

nondiscrimination as it relates to employment and employment related practices;

WHEREAS, the City's Municipal Code 9.130 provides for nondiscriminatory provisions as it

relates to the use of real or personal property owned by the City of Santa Barbara; and

WHEREAS, the City wishes to consolidate these policies into a uniform Citywide

Nondiscrimination Policy applicable to the conduct of all City business.

NOW THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF SANTA

BARBARA THAT:

1. The City of Santa Barbara reaffirms its commitment to equality in the conduct of City

business, and prohibits any policy, plan, program, custom or practice which has a discriminatory

effect related to race, creed, color, national origin, ancestry, sex, political affiliation, religious

beliefs, disability, sexual orientation, pregnancy, marital status or age.

2. This policy shall apply to members of the City Council, all advisory Boards, Commissions

and Committees, citizen volunteers, City employees and to those who do business with or who

seek to do business with the City of Santa Barbara.

Adopted November 9, 1993

I have read the above resolution, and if appointed, will follow it in the conduct of my

duties.

IGNATURE: ______________________________________________________

Form 13, Application for Appointment (8/27/2012) Page 4

EXCELLENCE IN CUSTOMER SERVICE

CODE OF CONDUCT

The Mayor and City Council; appointed members of Boards, Commissions, and Committees;

City’s employees; and its volunteers are committed to excellence in customer service. We

recognize that our customers are all who live in, do business in, and visit Santa Barbara. We

acknowledge that each of us has a responsibility to act according to the following core values:

ATTENTIVE

AND UNDERSTANDING

I will be a careful and understanding listener. I will be open to new ideas and will explore

alternatives.

RESPONSIVE

I will be available to provide service and will respond in an appropriate manner. I will be

thorough, efficient, and prompt.

HONEST

I will strive to be consistent and fair, and will give complete and honest information and

guidance.

COURTEOUS AND RESPECTFUL

I will be friendly and courteous. I will be respectful and understanding of others' issues and

needs.

KNOWLEDGEABLE

AND SOLUTION ORIENTED

I will take every opportunity to learn and improve my skills and knowledge. I will use that

knowledge to be resourceful and proactive in solving problems and reaching decisions. I will

look for creative and workable solutions to problems.

I have read the above Code of Conduct, and if appointed, will follow it in the conduct of

my duties.

IGNATURE: ______________________________________________________

NOTE: Appointees may be expected to participate in Excellence in Customer Service training

sessions.

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