Special Requirements & Qualifications (if any): RESIDENT OF SAN MATEO COUNTY and qualifications as listed on the Roster Information provided on this application is public information and may be made available to other applicants, members of the press, or the general public. This application may remain on file for six months from the date of submission. Name of Board, Commission, or Committee What position are you applying for? Would you be able to attend meetings at the following times? Day Night Either Contact Information Name Email Phone Address City/Town ZIP/Postal Code District:? Not sure which district you are in? Visit this link to input your address and check your Supervisorial District: https://bos.smcgov.org/ 1 2 3 4 5 Education Post-Graduate Bachelor's Degree Associate's Degree Certificate High School/GED Other Enter other… Are you a veteran of the U.S. Armed Forces? Yes No Please complete the following questions if you are a veteran of the U.S. Armed Forces. Years of Service Branch of Service Please provide the character of your discharge from military service.? Present Employer Position Employer Address Employment History Civic Activity Please include any present or past membership on county or city boards, committees, or commissions, or participation in the activities of community groups or organizations. Why are you seeking this appointment? Please include in your response any qualifications/special interests related to this position that may not have been covered. How did you become aware of the opening? Board Meeting County Website Newspaper Friend Social Media (Facebook, Twitter, etc.) Other Enter other… Please provide more detail on Social Media Facebook Twitter Nextdoor Other Enter other… Electronic Signature (Please enter your full name.) CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.