HomeMy WebLinkAboutItem 8.4 SB343 Human Services Task Force
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58 343
Senate Bill 343 mandates supplemental materials that have been
received by the City Clerk's office that relate to an agenda item after
the agenda packets have been distributed to the. City Council be
available to the public.
The attached document was received in the City Clerk's office after
distribution of the March 20, 2012 City Council meeting agenda
packet.
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Item 8.4
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HUMAN SERVICES TASK FORCE APPLICATION
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FULLNAM~, Ke ','-1, ~.. L~t~ v(~ (1-\,-..1 k-C\lO'"I'" ~,',
ADDRESS: ....~l- '.,-,_.. 'CITYINWHICHYOUlIVE '-
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TELEPHONE (Daytime): _" .
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(EvenIng):
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EMAILADDRESS: , ~'. -~, .- -. ~ 7
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BI YES 0 NO
PREFERRED DAY(S) OF THE WEEK: X/ (ll-- \~..$
ARE YOU ABLETO ATIEND MEETINGS DURING BUSINESS HOURS: (Bl YES 0 NO
PREFERRED TIMES: 'V{:LV I ~ S
DO YOU WISH TO SERVE ON THE TASK FORCE IN THE CAPACITY AS A: (check one or more)
o Faith Based prganlzation - name of church
J8I ComlJlunity Based Organizatipn or club - name of organization or club 11'" i ..- \/ (\..-1 I ~ 'i .' '1 MeA
o Dublin Resident, and are familiar with human services? 0 YES Ia NO
.0 Non Dublin R,esident, and are,familiar with human services? ~ YES 0 NO What City (\?-~1YV -/0-..1 Ie-Lt'
r-t? S l deV\t~ t7 L-l;t- n"L-I'V'ltl iceV'" iAJ ,*, 11 u..v,YI CL.-V\ 5C.V-'/ICe.s
OTHER INFORMATION OR COMMENTS: l-:;,'S U? 52. I i'l 1- v-i - V {L-{ 16~ I '
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SIGNATURE~ - :..\.-c./~.f~f:~? I JJ--
Deadline for ~PPlica~ons is Friday, March 2, 2012. Return application
to:. City of Dublin, City Clerk's Office 100 Civic Plaza, Dubiin, CA 94568, Attn: Patricia Parks
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