Application for Appointment to the Measure Z Citizens' Oversight Committee

Application for appointment to the Measure Z Citizen's Oversight Committee.

General Information

Name*

Answer required for "Name"

Home Address *

P.O. Boxes are not accepted

Answer required for "Home Address "

Telephone Number*

Number Required

Cell Phone Number

Number Required

Email Address*

Answer required for "Email Address"

Employment Information

Employer Name*

Answer required for "Employer Name"

Employer Address*

Answer required for "Employer Address"

Employer Telephone Number*

Number Required

Employer Email Address*

Answer required for "Employer Email Address"

Additional Information

Have you been a member of any district or school-based committee?*

Answer required for "Have you been a member of any district or school-based committee?"

Yes

If yes, in what capacity?

Answer required for "If yes, in what capacity?"

List present or past membership(s) in any community service, civic or youth organizations.

Answer required for "List present or past membership(s) in any community service, civic or youth organizations. "

List participation in seminars, workshops, volunteer work, professional organizations, etc.

Answer required for "List participation in seminars, workshops, volunteer work, professional organizations, etc. "

Qualifications: Describe your skills, training, and experience in finance, facilities, and/or construction.

Answer required for "Qualifications: Describe your skills, training, and experience in finance, facilities, and/or construction. "

Please answer the following questions:

How long have you been a resident in the Beaumont Unified School District? *

Answer in years and months

Answer required for "How long have you been a resident in the Beaumont Unified School District? "

Do you have or have you had children or grandchildren in the Beaumont Unified School District? *

Answer required for "Do you have or have you had children or grandchildren in the Beaumont Unified School District? "

Yes

Do you know of any reason such as a conflict of interest, which would adversely affect your ability to serve on the Citizens’ Bond Oversight Committee?*

Answer required for "Do you know of any reason such as a conflict of interest, which would adversely affect your ability to serve on the Citizens’ Bond Oversight Committee?"

Yes

If yes, please explain below.

Answer required for "If yes, please explain below. "

Explain why you would like to be appointed to this committee.*

Answer required for "Explain why you would like to be appointed to this committee."

The Oversight Committee must consist of seven members within specific categories as outlined in the Citizens’ Bond Oversight Committee Bylaws.

Prospective applicants must qualify as a member in one of the below categories: *

Answer required for "Prospective applicants must qualify as a member in one of the below categories: "

Member who is active in a business organization representing the business community located within the District

Member who is active in a senior citizen’s organization

Member who is active in a bona fide taxpayer association

Member who is the parent or guardian of a child enrolled in the District

Member who is either parent or guardian of a child enrolled in the District and active in a parent-teacher organization (such as PTA or School Site Council)

Member at large – Resident of the Beaumont Unified School District

Conflicts of Interest:

Employees, vendors, contractors, and consultants of the Beaumont Unified School District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.

Are you and employee of the District? *

Answer required for "Are you and employee of the District? "

Yes

Are you a vendor, contractor, or consultant to the school district? *

Answer required for "Are you a vendor, contractor, or consultant to the school district? "

Yes

Do you have conflicts that would preclude your attending meetings? *

Answer required for "Do you have conflicts that would preclude your attending meetings? "

Yes

Do you know of any reason, such as a potential conflict of interest, which would adversely affect your ability to serve on the Measure Z Citizens’ Bond Oversight Committee?**

Answer required for "Do you know of any reason, such as a potential conflict of interest, which would adversely affect your ability to serve on the Measure Z Citizens’ Bond Oversight Committee?*"

Yes

Are you willing to comply with the ethics code included in the bylaws?*

Answer required for "Are you willing to comply with the ethics code included in the bylaws?"

Yes

Do you agree with the Bylaws and are you willing to comply with the existing Bylaws? *

Answer required for "Do you agree with the Bylaws and are you willing to comply with the existing Bylaws? "

Yes

All answers and statements in this document are true and complete to the best of my knowledge. The information contained in this application may be made public when presented at a Board of Education Meeting. Submitted applications are only valid for 6 months from the date signed.

Signature*

Signature Required

Please fix the highlighted areas below before submitting.

Application for Appointment to the Measure Z Citizens' Oversight Committee