Application for membership on the Housing Advisory Commission

1

Prefix

Prefix

Mr.

Mrs.

Ms.

Mx.

Dr.

Other: If other, type text here.

N/A

2

Preferred Pronoun 

Preferred Pronoun

He/Him/His

She/Her/Hers

They/Them/Theirs

Ze/Hir/Hirs

Ey/Em/Eirs

Other: If other, type text here.

3

First and Last Name

 *

First and Last Name

4

Email

 *

Email

5

Residence Address

 *

Residence Address

6

City

City

7

ZIP Code

 *

ZIP Code

8

Primary Phone

 *

Primary Phone ext.

9

Secondary Phone

Secondary Phone ext.

10

I certify that I am a resident of the City of Chula Vista and at least 18 years of age

 *

I certify that I am a resident of the City of Chula Vista and at least 18 years of age (Select an Answer) Yes No

11

How long have you been a resident of the City?   

How long have you been a resident of the City?

12

Please click here to view the interactive map and verify your District of residency

I am a resident of the following City Council district.

 *

Please click here to view the interactive map and verify your District of residency I am a resident of the following City Council district. (Select an Answer) 1 2 3 4

13

Employer

 *

Employer

14

Occupation

 *

Occupation

15

Have you ever been employed by the City of Chula Vista?

 *

Have you ever been employed by the City of Chula Vista?

Yes

No

16

If you have worked for the City of Chula Vista please provide the department and dates of employment.

If you have worked for the City of Chula Vista please provide the department and dates of employment.

17

Please select the seats for which you are interested and qualify: (select as many as applicable)

 

 *

Please select the seats for which you are interested and qualify: (select as many as applicable)

Expertise Seat (members must have expertise and experience in at least one of the following fields: lending, urban planning, real estate development, or real estate brokerage)

Housing Authority Tenant Representative (this member shall, at the time of their appointments and throughout their terms, reside in assisted housing or receive Section 8 rental housing assistance from the Housing Authority)

Housing Authority Tenant Representative - 62 years of age or older (this member shall, at the time of their appointments and throughout their terms, reside in assisted housing or receive Section 8 rental housing assistance from the Housing Authority)

Resident of the City At-Large

18

If you selected the Expertise Seat above, please describe your expertise and experience in the listed field(s). (250 words or less)

 *

If you selected the Expertise Seat above, please describe your expertise and experience in the listed field(s). (250 words or less)

19

Have you previously served, or do you currently serve, on a Chula Vista Board, Committee or Commission

 *

Have you previously served, or do you currently serve, on a Chula Vista Board, Committee or Commission

Yes

No

20

If yes, which one(s) and for what period of time?

If yes, which one(s) and for what period of time?

21

Per Chula Vista Municipal Code Section 2.25.030, I understand:

-If I am currently serving on a board or commission, I must resign from my current board or commission if I am appointed.

-I must have served at least 12 months on my current board or commission in order to be appointed to another board or commission.

 *

I have read and acknowledged the above statement.

22

Are you, or have you been, involved in any local, civic, service or community groups?

 *

Are you, or have you been, involved in any local, civic, service or community groups?

Yes

No

23

If yes, please list them

If yes, please list them

24

What do you hope to accomplish in the role of a Housing and Homelessness Advisory Commissioner? (250 words or less)

 *

What do you hope to accomplish in the role of a Housing and Homelessness Advisory Commissioner? (250 words or less)

25

You may upload a resume in addition to your application (optional).

You may upload a resume in addition to your application (optional). Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

26

The City understands meeting schedules and individual's availability may change. We ask that you consider the meeting schedule when submitting an application.

I have reviewed the Housing and Homelessness Advisory Commission regular meeting date, time and frequency.

27

 *

I am familiar with the responsibilities of the Housing and Homelessness Advisory Commission. I attest that the information I have provided is accurate and true.

28

 

 *

I understand that this application and any documents submitted in connection with the application process are public records and may be publicly disclosed.

29

Where did you hear about this vacancy?

Where did you hear about this vacancy?

City’s Social Media

Chula Vista Library

City’s Website

City Employee

City Board/Commission Member or Staff

Other (please enter text below) If other, type text here.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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