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Commission / Committee / Board Application

  1. Applicant Information

  2. Current Employment

  3. Are you a registered voter in the City of Wasco?

  4. Personal References (list two)

  5. Authorization and Release

  6. I understand that in connection with this application for appointment, the information contained herein will be made available to the general public upon request.

  7. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  8. NOTE: This document is a public record and may be disclosed/released pursuant to the California Public Records Act. Appointees and incumbents shall file the Statement of Economic Interest forms as required by the State of California. For example, the statement could include source of income, real property investments, and/or savings accounts within the City of Wasco depending upon the appointment.

  9. Leave This Blank:

  10. This field is not part of the form submission.