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<br />~ <br />;\'~~"" ',:'-" '., . " <br />. .,.. <br /> <br />CITY OF SANTA ANA <br />CITY COUNCIL MEMBER VACANCY <br />APPLICATION & INTEREST STATEMENT <br /> <br />Name <br /> <br />First <br /> <br />Middle <br /> <br />Last <br /> <br />Home Address <br /> <br />Zip Code <br /> <br />Phone <br /> <br />Fax <br /> <br />City <br /> <br />Zip Code <br /> <br />Phone <br /> <br />Length of time residing in Ward 1 <br /> <br />Occupation <br /> <br />Employer <br /> <br />Birth Date <br /> <br />Spouse's Name <br /> <br />Y ears Lived/Worked in Santa Ana <br /> <br />Organizations (Professional, Community, Service or other) <br /> <br />Educational Background <br /> <br />REASON FOR INTEREST IN THIS POSITION: <br /> <br />1. I am interested in serving on the City Council for the following reasons: (Please use additional paper if necessary.) <br /> <br />2. From your point of view, what are the three greatest needs and challenges of/for the city at this time? (Please use <br />additional paper if necessary.) <br /> <br />3. What are the greatest opportunities for the City from your perspective? (Please use additional paper if necessary.) <br /> <br />I have completed this application with the knowledge and understanding that any or all items may be verified. I consent to <br />the release of information contained in this application to interested parties. YES NO <br />(Please Circle) <br /> <br />SIGNA TURE <br /> <br />Date <br /> <br />PLEASE ATTACH A RESUME DETAILING YOUR COMMUNITY INVOLVEMENT <br /> <br />658-3 <br />