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Print Form <br />List Board(s) / Commission(s) 1) Select first choice: Planning Commission <br />you would like to serve on: 2) Select second choice: <br />3) Select third choice: <br />I am a registered voter in the City of Santa Ana. I have completed this application with the knowledge and <br />understanding that any or all items may be verified, and affirm I have received the Ethics Code, understand its <br />provisions, and pledge to conduct my duties consistent with the code if appointed to a City Board or Commission. <br />I consent to the release of information contained in this application to interested parties. I further understand that <br />the Santa Ana Police DepartmentAonducts a routine background check on applicants nominated for appointment. <br />SIGNATURE k'l DATE <br />This field must be completed in order for the application to be processed. <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 />CITY OF SANTA ANA <br />x y <br />APPLICATION FOR SERVICE <br />e i1 2: BOARDS COMMISSIONS / COMMITTEES <br />Name (Mr., Mrs., Ms.) Phil Bacerra A <br />FIRST MIDDLE LAST <br />Home Address 2226 Alona Street Ward: QuaIifierl Ele r: 3,, l <br />this area, to be completed by Clerk staff.) <br />Zip Code 92706 Home Phone N/A Fax N/A <br />E -Mail philbacerra@gmail.com Cell (323) 363-6063 Other N/A <br />Employer Jacaranda Enterprises Occupation Land Use Consultant <br />Work Address PO Box 2636 <br />City Garden Grove Zip Code 92842 Work Phone (323) 363-6063 <br />Soc. Sec. No.* Driver's License No. Date of Birth <br />Years Lived/Worked in Santa Ana 8 years Language(s) Spoken English <br />Organizations (Professional, Community, Service or other) OCTA Citizens Advisory Committee, <br />Qualifications, Experience, Education Bachelor of Science in Urban Planning & Development from USC. <br />13 years of professional planning experience in the public and private sectors, <br />Remarks (attach resume if available) Please see attached resume. <br />List Board(s) / Commission(s) 1) Select first choice: Planning Commission <br />you would like to serve on: 2) Select second choice: <br />3) Select third choice: <br />I am a registered voter in the City of Santa Ana. I have completed this application with the knowledge and <br />understanding that any or all items may be verified, and affirm I have received the Ethics Code, understand its <br />provisions, and pledge to conduct my duties consistent with the code if appointed to a City Board or Commission. <br />I consent to the release of information contained in this application to interested parties. I further understand that <br />the Santa Ana Police DepartmentAonducts a routine background check on applicants nominated for appointment. <br />SIGNATURE k'l DATE <br />This field must be completed in order for the application to be processed. <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 />C-29