APPLICATION FOR APPOINTMENT AS PLEASANT HILL CITY CLERK

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High School. Graduate? Yes ____ No ____. College. Graduate? Yes ____ No ____. Graduate School. Trade School __. Special
APPLICATION FOR APPOINTMENT AS PLEASANT HILL CITY CLERK Name____________________________________________________________________________ Last

First

Address___________________________________________________________________________ Telephone______________________ Email Address_____________________________________ Occupation ______________________ Employer ________________________________________ Can you attend City Council meetings? Yes ____ No ____ Are you a resident and registered voter in Pleasant Hill? Yes ____ No ____ Educational Background: High School _______________________________________ Graduate? Yes ____ No ____ College ___________________________________________ Graduate? Yes ____ No ____ Graduate School ________________________________________________________________ Trade School __ ________________________________________________________________ Special Schooling _______________________________________________________________ Do you have any special skills or knowledge that you believe would be helpful in serving as the City Clerk? Explain.

Please provide any further information or comments that would be helpful in reviewing your application.

Signature ______________________________________________

Date ____________________

Note that this application and the information it contains is a public record. Thank you. Return this form to: City of Pleasant Hill City Manager’s Office 100 Gregory Lane Pleasant Hill, CA 94523-3323

Revised June 2014