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01 Attachment 3 CSTC Application.MASTERTOWN OF LOS GATOS BOARD, COMMISSION, COMMITTEE APPLICATION Contact: Clerk Department 110 East Main Street, Los Gatos, CA 95030 (408) 354-6888 or Clerk@LosGatosCA.gov General eligibility requirements: A resident of the incorporated limits of the Town of Los Gatos. Other requirements may apply to specific Boards, Commissions, or Committees. If you would like to apply for more than one Board, Commission, or Committee, place a number next to the Board, Commission, or Committee, in order of your preference, for which you would like to apply. A separate application is required to be submitted for each Board, Commission, or Committee you are applying for. Only applications for current openings will be considered at this time. Applications for future openings will be kept on file for one year. Qualified applicants will be notified for an interview with Town Council. __ Arts and Culture Commission __ Building Board of Appeals __ Community Health and Senior Services Commission __ Complete Streets and Transportation Commission __ Council Finance Committee – Resident __ General Plan Committee __ Historic Preservation Committee __ Library Board __ Parks Commission __ Personnel Board __ Planning Commission __ Sales Tax Oversight Committee IMPORTANT NOTICES Please note that all information provided on the application becomes a public record after it is officially filed. All appointed applicants are required to file the Fair Political Practices Commission (FPPC) Statements of Economic Interest (Form 700), which are also a public record. Applicants appointed to the Planning Commission are also required to complete Ethics Training AB 1234 every two years. CONTINUE TO PAGE 2 ATTACHMENT 3 FIRST NAME: LAST NAME: ADDRESS: CITY: ZIP CODE: CELL PHONE: WORK PHONE: EMAIL ADDRESS: HOME PHONE: EMPLOYER: JOB TITLE: HOW LONG HAVE YOU LIVED IN LOS GATOS? *If appointed your name, phone number, and email address will be made available to the public. Please list all previously held elected or appointed governmental positions. Include the Position/Office held and the associated dates. (e.g. Mayor, City of San Jose, 1990-1994) Please list any civic charitable organizations you have belonged to. Include the Position/Office held and the associated dates. (e.g. Coach, Little League, 1982-1989) Please list any schools that you have attended or are currently attending. Include your major subject area and/or grade level. (e.g. San Jose State University, BA in History) CONTINUE TO PAGE 3 Why are you interested in serving on the Complete Streets and Transportation Commission? What do you see as the role of this Commission? How will you balance your personal interests with the broader role of the Commission? CONTINUE TO PAGE 4 How do you stay in touch with the overall priorities of the community? Do you prefer an active role in advancing priorities or a formal advisory role? All applicants are required to be interviewed to be considered for appointment as a Commissioner. All applicants will be contacted via email with the interview date and time. Signature: Date: IN COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT, IF YOU NEED SPECIAL ASSISTANCE TO PARTICIPATE IN THE INTERVIEW PROCESS, PLEASE CONTACT THE CLERK DEPARTMENT AT (408) 354-6834. NOTIFICATION 48 HOURS BEFORE THE MEETING WILL ENABLE THE TOWN TO MAKE REASONABLE ARRANGEMENTS TO ENSURE ACCESSIBILITY [28 CFR §35.102-35.104]