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Application for city commission


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City of Duarte

1600 Huntington Drive

Duarte, California 91010

Phone (626) 357-7931


APPLICATION FOR CITY COMMISSION


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There are six City Commissions. Please mark by number your preference(s), listing (1) as your first preference, etc. Three Commissions include both Duarte residents and non-residents. If one of those Commissions is your preference, please also circle the ONE membership category for which you are applying.




Planning Commission Public Services Commission Traffic Safety Commission






Public Safety Commission (Circle one below)

-Resident of Duarte

-Business owner/operator

-School District representative

-Resident of unincorporated area

-MAD Town Council representative

-L.A. County Supervisor representative

-L.A. County Human Relations Commission

Parks and Recreation Commission (Circle one)

-Resident of Duarte

-Non-resident of Duarte

-Senior citizen representative

-School District
Economic Development Commission (circle one)

-Resident of Duarte

-Business owner/operator

I. PERSONAL


_________________________________________ Home Phone _______________________

Name (Last, First, Middle)

_________________________________________ Work Phone ________________________

Home Address (Number and Street)

_________________________________________ Email_____________________________

(City, State, Zip Code)


II. ELIGIBILITY


Eligibility to serve on a City Commission depends on which Commission you are interested in. All Commission applicants are required to file a City application, and have no felony convictions. Please see the attached sheet for eligibility information.

Have you ever been convicted of a felony? ____Yes ____No

III. QUALIFICATIONS AND STATEMENT OF INTEREST


Please submit a written statement of not more than two hundred words describing background, qualifications, and objectives in serving on the Commission. You may also attach a résumé in addition to the statement.

IV. ADDITIONAL REQUIREMENTS/INFORMATION


  • Form 700, Statement of Economic Interests – Must be filed with the City Clerk by all Commissioners pursuant to State Law, and it becomes a matter of public record. The form requires a disclosure of real property (excluding your home), investments other than retirement, certain gifts you may have received, and other financial disclosures. Form 700 is currently filled out by the City Council, Planning Commission, and many City staff members.

  • Training Session – All City Commissioners are required to complete a two-hour Ethics Training course once every two years. The Certificate of Completion is kept on file with the City Clerk.

By signing below, I declare under penalty of perjury that the information contained in my application is true and correct, and does not contain any material misrepresentations or omissions.
_________________ ______________________________________

Date Signature




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