Solano County Seal
Application for Membership on
Advisory Board, Council, Committee or Commission

 
Return application to the Clerk of the Board of Supervisors
By mail or delivery to: Clerk of the Board of Supervisors, 675 Texas Street, Suite 6500, Fairfeld, CA 94533
Or you may also submit your application by clicking on the submit button at the end of this application.

All fields marked with an * are required
* Name of Board, Council, Committee or Commission:
* Supervisorial district in which you reside:       
* If this board, council, committee or commission calls for a specific type of member, please indicate the position for which you are applying
Contact Information
* First Name:
Middle Name:
* Last Name:
Residential Address
* Address:
* Email:
* City:
* State:
* Zipcode:
* Home Phone:
* Cell Phone:
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Business Address
* Address:
* Email:
* City:
* State:
* Zipcode:
* Business Phone:
* Alternate Phone:
District & Meeting
* Will you be available to attend board/council/committee/commission meetings regularly? Yes No
Memberships in Other Organizations (list name and address):

Organization 1

* Name:
* Address:




* City:
* State:
* Zipcode:



Organization 2

Name:
Address:




City:
State:
Zipcode:



Organization 3

Name:
Address:




City:
State:
Zipcode:
Employment & Educational History
* Please provide a brief description of your employment & educational history: (resume may be attached): Max Characters: 2500
Attach Resume Acceptable file extensions (.doc, .docx, .pdf, .txt)



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Please list a minimum of 3 professional references:
* Name:









* Email:









* Phone:









General Information
* As a member of this board/council/committee/commission, what might you hope to achieve? Max Characters: 2500
* As a member of this board/council/committee/commission, what do you think you might contribute to help it fulfill its missions and goals? Max Characters: 2500
Important Information

  • This application is a public document and is subject to the California Public Records Act (CA Gov. Code ยง6250-6270).
  • All members are required to take the following training: 1) The Brown Act and 2) State Ethics Training Course as maybe required by AB 1234.
  • Members of boards, councils, commissions and committees may be required to file a Statement of Economic Interest Form also known as a Form 700.
  • Advisory body meetings may be held in various locations and some locations may not be accessible by public transportation.
  • Meeting dates and times are subject to change and may occur multiple days per month.
  • Some boards, councils, commissions or committees may assign members to subcommittees or work groups which may require an additional commitment of time.

I CERTIFY that I have read and understand the information above, and that the statements made by me in this application are true, complete, and correct to the best of my knowledge and belief. I acknowledge and understand that all information in this application is publicly accessible. I understand and agree that misstatements/omissions of material fact may cause forfeiture of my rights to serve on a Board, Council, Commission or Committee in Solano County.

By typing your name here, you are signing this form electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
* Applicant Signature:
* Date: