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d4 ffsN,re <br />y "` <br />r <br />CITY OF SANTA ANA <br />4 NM DEC -5 PM 5: no <br />47 .4.0 APPLICATION FOR SERVICE <br />BOARDS/ COMMISSIONS /COMMIT(TRES [ ti A N#T l-:o • <br />e ;`.k' <br />ti GLEE; GE 1 " , <br />Ir <br />l <br />Name (Mr., Mrs., Ms.) STEVEN ANTHONY NGUYEN <br />FIRST MIDDLE LAST <br />1509 EASTSIDE AVE <br />OFFICE USE ONLY <br />Home Address Ward: Qualified Elector: <br />PD Background: Date to Council:_ <br />I <br />Zip Code 92701 Home Phone 7143362271 Fax <br />E-Mail NGUYENSTEVEN3O@GMAIL.COM Cell 7143362271 Other <br />Employer STATE OF CALIFORNIA Occupation DISTRICT DIRECTOR <br />Work Address 3 POINTE DRIVE, SUITE 313 <br />City BREA Zip Code 92821 Work Phone 714-529-5502 <br />Soc. Sec. No.` Driver's License No. Date of Birth 01/30/1990 <br />Required <br />Years Lived/Worked in Santa Ana 28 Language(s)Spoken ENGLISH, LIMITED SPANISH <br />Organizations(Professional, Community, Service or other) YDS,Our Lady of Peace.Komi!,° cholla Center,SA MIctrIcePPritasnallan sooIe (PtnetwoMo eeuuec•summer 2014) <br />Alzhelmefs Associalion,Oversight Board or the Sucoessor Agency to the Former Community Redevelopment Agency,City of Santa Ane,Board Member—OC Republiosn Party Central Committae <br />Qualifications, Experience, Education Employed by OC Probation Department(10/2015.4(2018),Currently employed by CA Stale Assembly <br />Board Member for Oversight Board of the Successor Agency to the Former Community Redevelopment Agency of the City of Santa Ana <br />Remarks( attach resume if available) <br />List Board(s)/Commission(s) 1) select Frit cholae: Historic Resources Commission <br />you would like to serve on:2) selectSecondehmce: Planning Commission <br />3) SSC(Third Choice: Community Redevelopment and Housing Commission <br />I am a registered voter In the City of Santa Ana. I have completed this application vrith 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'Pftllce 5apartment conducts a routine background check on applicants nominated for appointment, <br />SIGNATURE DATE <br />ifY714l11- <br />This Heaton will be retained on file in the Clerk of the Council Office for 2 years. <br />Please note that the Code 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 - 31