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Commission/Committee/Board Application for Appointment/Reappointment

  1. Note: There is no specific educational requirement

  2. Do you have any financial or professional interest or association related to this position?*

  3. A resume containing other pertinent information about yourself would be helpful to the City Council in evaluating your application.

  4. Application Certification: Please Read Below

    I certify that the statements made by me in this application are true, complete, and correct to the best of my knowledge and belief. I understand that statements made are subject to verification and that any misrepresentation, fraud, or omission of material facts may result in denial of appointment/reappointment. I hereby authorize representatives of the City of Patterson to contact organizations (including employers and schools) and individuals listed, for the purpose of establishing or verifying my qualifications and work history in connection with this applicaiton. I understand and acknowledge that such information will be used confidentially and for the purpose of appointment/reappointment decisions only. I understand and hereby accept that if the City Council of the City of Patterson appoints/reappoints me to a City of Patterson Commission/Committee/Board, I will serve without pay and will be subject to the filings of the Fair Political Practices Commission (Statement of Economic Interest, Form 700). I hereby further understand and accept that per City Ordinance No. 718, if I am appointed/reappointed, I wil be required to pass a Department of Justice (DOJ) fingerprint (background) test.

  5. I certify that I have read and agree with the above statement.*

  6. The City Clerk's Office will keep your application on file for one (1) year from the date received.

  7. Leave This Blank:

  8. This field is not part of the form submission.