Office of the City Clerk

City Boards and Commissions

Position	Board Commission
Board or Commission Name
Your Name
Date

Home Address
Zip Code
Telephone No.
E-Mail Address

Business Affiliation
Title
Business Address
Zip
Telephone No.

Are you a resident of San Diego?	Yes No
Length of Residence in San Diego
Council District (Select One)	1 2 3 4 5 6 7 89

Educational Background
Occupational Experience
Professional or Technical Organization Memberships
Civic or Community Experience, Membership, or Previous Public Service Appointments
Experience or Special Knowledge Pertaining to Area of Interest
Please feel free to provide additional information or letters of endorsement. Thank you for your interest in serving City government.

Form CC-1670-HTML (Rev. 2/13/2013)