City Forms - Commission for the Senior Community Application

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Commission for the Senior Community Application

Members must be registered voters in the City of Santa Monica and may not hold paid office or employment in the City Government.

The Oaks Initiative, also known as the "Taxpayer Protection Act," was adopted by Santa Monica voters on November 2000, and amends the City Charter. Its requirements affect all City-elected and appointed officials, including Council-appointed board and commission members. Related litigation on this matter recently concluded, and accordingly, the City is implementing the Initiative. The City Attorney prepared the following information about the Initiative that may affect you if you are appointed to a Santa Monica Board or Commission. Please read it carefully before completing your application. Select the format you would like to view: html | PDF | MS-Word

Members must be registered to vote in the City of Santa Monica. At least five of the commissioners shall be over 60 years of age. None of the voting members shall hold any paid office or employment in City Government.

* indicates required information

INFORMATION TO BE DISPLAYED ON INTERNET:

Prefix*:
First Name*: Middle Name:
Last Name*:
Public Address:

City: State: Zip:
Phone: format (xxx) xxx-xxxx Fax: format (xxx) xxx-xxxx
E-mail:

Reside in Santa Monica*?	Yes	No	No. of years
Registered to vote in Santa Monica*?	Yes	No
Do You hold an elected position*?	Yes	No	If yes, position
Are you applying for one of the seats reserved for those over the age of 60*?	Yes	No

Specify current or prior service on City Boards/Commissions:

List Community activities in which you are involved:

Describe your qualifications, experience, and education, and list any technical or professional requirements you have relative to the duties of the Commission for the Senior Community.

What are your goals in serving on the Commission for the Senior Community?

BUSINESS INFORMATION: OKAY TO DISPLAY ON INTERNET*? Yes No

Occupation*:
Bus. name:
Bus. address:

City: State: Zip:
Phone: format (xxx) xxx-xxxx Fax: format (xxx) xxx-xxxx

FOR CONFIDENTIAL USE ONLY:

Residence Address*:

City*: State*: Zip*:
Phone*: format (xxx) xxx-xxxx Cellular: format (xxx) xxx-xxxx
ALL INFORMATION, EXCEPT INFORMATION ENTERED IN THE CONFIDENTIAL SECTION, IS PUBLIC AND AVAILABLE FOR VIEWING AT THE CITY CLERK'S OFFICE AND ON THE CITY'S WEB PAGE (EXCEPT AS NOTED ABOVE).

DISABILITY RELATED ASSISTANCE AND ALTERNATE FORMATS OF THIS DOCUMENT ARE AVAILABLE UPON REQUEST BY CALLING (310) 458-8211

This page was last modified on 05/29/2008

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