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Application for Appointment to Commission or Board

  1. Note:

    Your application / biographical information will be copied for the City Council and made available to the press and public. The application process includes a video interview.

  2. Board / Commission*

    Please select one or more positions you are interested in.

  3. Personal Data

  4. Applicants must be a resident of the City of Citrus Heights.

  5. Are you presently serving on a City commission or board?*

  6. Employment / Experience

  7. If retired, please indicate former occupation or profession.

  8. AB 1234 Ethics Training:

    Every newly appointed board or commission member is required to complete the AB 1234 Ethics Training required by California Government Code 53234 within the first year of appointment and every two years thereafter. Noncompliance will result in automatic removal as detailed in the City Council Handbook (adopted October 2020).

  9. AB 1661 Sexual Harassment Prevention Training and Education:

    Every newly appointed board or commission member is required to complete the AB 1661 Sexual Harassment Prevention and Education required by California Government Code 53237.1 within the first six months of appointment and every two years thereafter.

  10. Statement of Economic Interest Form 700:

    Pursuant to the Political Reform Act and the City's Conflict of Interest Code public officials are required to file a Statement of Economic Interest Form 700 upon appointment / assuming office.

  11. Applicant Acknowledgement*

    By submitting this form, I hereby declare, under penalty of perjury, that all statements in this application are true and complete to the best of my knowledge and belief.

  12. Leave This Blank:

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