HomeMy WebLinkAboutSR CITIZEN ADV COUNCIL 04-01-85DATE: March 29, 1985
TO:
FROM:
SUBJECT:
Mayor and City Council
Jeff Kolin, Recreation Superintendent
SENIOR CITIZENS ADVISORY COUNCIL NOMINATION
RECOMMENDATIONS:
Nominate Ruby M. May to serve as a representative for the City of Tustin on the
County of Orange Senior Citizens Advisory Council and authorize the City Manager
to sign the application.
BACKGROUND:
Ruby M. May has been an active member of the community for many years. She has
served as an alternate member of the County of Orange Senior Advisory Council
for 2 1/2 years and as a voting member for the oast year. Seniors in Tustin
respect Ruby's knowledge and trust her to represent them on the County Advisory
Council.
Representation on the Senior Advisory Council is becoming increasingly important
as more legislation is proposed affecting seniors and Senior Grant Funds become
available. Staff whole-heartedly supports Ruby M. May's continued service on
the Senior Advisory Council. She will insure that Tustin continues to have a
voice on the important issues affecting seniors in our cQmmunity.
Jeff Kolin
Recreation Superintendent
JK:ls
COUNTY OF ORANGE
APPLICATION FOR APPOINTMENT TO SENIOR CITIZENS ADVISORY COUNCIL
I WISH TO BE CONSIDERED FOR APPOINTM~NT TO THE FOLLOWING M~ERSHIP CATEGORY OF THE ORANGE
COUNTY SENIOR CITIZENS ADVISORY COUNCIL:
1. Voting Member ;~ 2. Alternate Member to Voting Member
(name)
3. Committee Member on
(committee name)
NAME (Please Print)
' Las~ ' 'First Y
BIRTH DATE:
da7 mont~
EDUCATION A~ TRAINING:
~, High School Graduate
Junior College Graduate
College Graduate
Advanced Degree
ADDRESS:
/'/c ,v/s "7
Middle Initial No. and street
City Zip
year
Major
Mai or
WORK AND/OR VOLUNTEER EXPERIENCE
List your present or most recent Job and any other related experience including volunteer
experience which you feel would relate to your effectiveness as a member of the Council:
From ?lAgah J%"R '1 To ~..~%~w T
(date)
Title:
Employer/Agency: ....
Description of Duties:
(date)
Title: ~'~,iT#
REFERENCES: Give names of persons other than relatives or former employers:
Name Address City State. Telephone
.<-_,. %<- d ~ ~,.-~ ~ ~" ' ;~' ..
· ~ ~o~os-3 (3/8~) (continued on reverse)
THE FOLLOWING QUESTIONS AR~ ANSWERED IN ORDER THAT ~.MBERSHIP MAY BE CONSTITUTED IN RELATION
TO STATE AuND FEDER~ REQUIItE~S:
1. Ih.~· ,~,' ~a~__ am not a participant in senior programs in my community (describe if
2. I am in the population group as indicated below:
?opulation Group
Black
Asian
Hispanic
American Indian
Caucasian
Service Provider (unpaid)
Service Provider (paid)
Elected Official. Name position__
Represent interests of the disabled
Low Income
I understand that the Council and its co,,~,ittees meet once a month and that absence from
three consecutive meetings causes forfeiture of the appointment. I further understand that
effective July 1, 1981 Voting and Alternate members will receive $20 per month if attending
the monthly Council meeting, and that Committee members receive no remuneration. I further
understand that Council Voting and Alternate members are required to file a Conflict of
Interest Disclosure Statement ~ri~hin thirty (30) days of appointment and annually thereafter.
'(Applican~' s Signaturep
The above named person is a nominee of this organization for appointment on the Senior
Citizens Advisory Council as indicated. (Note: If a non-profit organization or municipality
this section should be signed by the Chairman of the governing body. If some other type of
organization, signature should be that of Chief Executive Officer)
Organization Name:
Address:
Telephone:
(Organizational Sponsor)
Name
Title
Date