WLASNC Board of Directors or Committee Application

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The information contained on this form will be used by the West Los Angeles Sawtelle Neighborhood Council to fill vacancies on the Board of Directors or a Committee. Separate applications must be submitted for each position to which you are applying.

Email *

Name *

First and last name

Address *

Phone *

Business Name

(if applicable)

Business Address

(if applicable)

Business Phone

(if applicable)

Business Email

(if applicable)

I am applying for the following Board of Directors [BOD] position or Committee: *

Separate applications must be submitted for each position to which you are applying.

[BOD] North West Representative (North of Nebraska / West of Barrington)

[BOD] North East Representative (North of Nebraska / East of Barrington)

[BOD] South West Representative (South of Nebraska / West of Barrington)

[BOD] South East Representative (South of Nebraska / East of Barrington)

[BOD] Large Business Representative (20 or more employees)

[BOD] Small Business Representative (19 or fewer employees)

[BOD] Organizational Representative

[BOD] At-Large Representative

Budget and Finance Committee

Bylaws Committee

Communications and Outreach Committee

Diversity, Equity, and Inclusion Committee

Environmental Committee

Planning, Land Use, and Management (PLUM) Committee

Public Safety Committee

Youth Committee

Ad Hoc Committee (describe below)

Other (describe below)

Required

Ad Hoc or Other (if applicable):

Describe below.

The following qualifies me as a Stakeholder of the WLASNC

Check all that apply.

I live within the boundaries of the WLASNC

I work within the boundaries of the WLASNC

I own property within the boundaries of the WLASNC (list property address below)

I own a business within the boundaries of the WLASNC (list business name and address below)

Required

Please describe your reasons for seeking the position to which you are applying. *

Please describe any relevant experience (e.g., work, volunteer) which you believe qualifies you for the position you are seeking. Please include dates. *

Please describe any relationships (e.g., professional, personal, financial, etc.) which could possibly be construed as a potential conflict of interest with the position you are seeking. Be aware that while such a relationship does not necessarily disqualify you from the position, you will be required to recuse yourself from any vote or decision that could be construed as a conflict of interest or from which you would possibly receive gain. *

I understand that if I am accepted to this Board or Committee position, I will be subject to the WLASNC Bylaws as well as the Brown Act, and that violations of these rules may be grounds for immediate removal from my position. *

Yes

I certify that the above information is accurate to the best of my knowledge and is subject to verification. *

Type your full name as signature.

Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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