CITY OF
RIDGECREST
Application for Citizen Service
As a member of:
Planning Commission Personnel Commission
Handicap Access Appeals Board Construction Appeals Board
Measure Advisory Committee Other
SPECIAL QUALIFICATION REQUIREMENT
Are you representative of any of the following categories:
Physically Disabled Structural Engineer
Architect General Contractor
Lay Member of the Public
Specialty Contractor (other than one from a trade regulated by the codes)
Date: Home Phone: Work Phone:
E-mail: Cell Phone:
Name:
Address:
Occupation:
Why are you interested in this position?
What do you consider to be your major qualification(s)?
Are there any days or work day evenings you could
NOT
meet? If so, please list:
Please list any additional information you feel would be useful to the City Council
Please return completed form to:
City Clerk
City of Ridgecrest
100 W California Ave
Ridgecrest, CA 93555 Applicant’s Signature
*Address MUST be within city limits to serve on any committee
