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CITY OF SANTA ANA <br />APPLICATION FOR SERVICE <br />BOARDS / COMMISSIONS / COMMITTlift 1`40V 10 Art ET 19 <br />Name (Mr., Mrs., Ms.) Edward <br />FIRST <br />Home Address 2139 N. Flower St. <br />Zip Code 92706 Home Phone 714 -313 -6980 <br />Allen <br />MIDDLE <br />CITY OF SANTA A -Us <br />CLERK OF C(1. .` <br />Murashie <br />LAST <br />OFFICE USE ONLY <br />Ward: j Qualified Elector: $ 1 <br />PD Background: Data to Council-it <br />Fax <br />E -Mail EMurashie @ProEngineered.com Cell 714- 313 -6980 Other <br />Employer ProEngineered Solutions LLC Occupation President - Senior Engineer <br />Work Address 2139 N. Flower St. <br />City Santa Ana Zip Code 92706 <br />Soc. Sec. No.* Driver's License No. <br />Required <br />Work Phone 714- 519 -6005 <br />Date of Birth <br />Years Lived/Worked in Santa Ana 2/10 Language(s) Spoken English <br />Organizations (Professional, Community, Service or other) Santa Ana Connect -To- Council, Floral Park Neighborhood Board, California Preservation <br />Foundation, Santa Ana Historical Preservation Society, Orange County Historical Society, licensed Santa Ana based business owner and Brea Radio Amateur Civil Emergency Services, <br />Qualifications, Experience, Education Santa Ana Historic Registry designee, attends the Historic Resources Commission (HRC) meetings regularly, <br />attended the three HRC preservation training sessions, community activist and MSEE Cal Poly Pomona 1985 graduate. Sea attached sheet for further qualification. <br />Remarks (attach resume if available) <br />List Board(s) / Commission(s) 1) <br />you would like to serve on: 2) <br />3) <br />Select Flrst Choice: Historic Resources Commission <br />Select Second Choice: Historic Resources Commission <br />Salem Third Choice: Historic Resources Commission <br />I am a registered voter in the City of Santa Ana. 1 have completed this application with the knowledge and understanding that any or all items may <br />be verified, and affirm I have received the Ethics Code, understand its provisions, and pledge to conduct my duties consistent with the code if <br />appointed to a City Board or Commission. I consent to the release of information contained in this application to Interested parties. I further <br />understand that the Santa Ana Police Department conducts a routine background check on applicants nominated for appointment. <br />SIGNATURE . e DATE <br />T <br />This application will be retained on file in the Clerk of the Council Office for 2 years. <br />Please note that the Code of Ethics and Conduct Certification must be signed and received by the Clerk of the Council Office <br />prior to nomination to a commission /board. <br />D - 28