Hayward, CA: Board Application

Profile

Upon submission to the City of Hayward, this application becomes a public document.

First Name *
Middle Initial
Last Name *

Email Address *

Home Address *
Suite or Apt
City *
State *
Postal Code *

Primary Phone * Primary Phone
Alternate Phone Alternate Phone

Which Boards would you like to apply for? *

This board does not have a vacancy

If applying for multiple bodies, please rank your choices in priority order: *

Resident of Incorporated Hayward: * Yes No

Length of Residency in Hayward *

Demographics

The City of Hayward believes that the makeup of City's Boards, Commissions, Committees and Task Forces should reflect the diversity of the community.

What is your Ethnicity? *

What is your Gender? *

Do you identify as LGBTQIA+? *

Age *

Employment/Community Activity History

Use the space below to list your work experience and/or community service experience:

Employment or Volunteer: *

Organization Name: *

Organization's Address: *

Title *

Time Period: *

Additional Employment/Community Activity History (if applicable):

Employment or Volunteer:

Organization Name:

Organization's Address:

Title:

Time Period:

Additional Employment/Community Activity History (if applicable):

Employment or Volunteer:

Organization Name:

Organization's Address:

Title:

Time Period:

Education/Training/Certification

List any education, training and/or special certifications relevant to serving on any City of Hayward Board, Commission, Committee or Task Force.

What is the highest degree or level of school that you have completed? *

Name of School, College, University or Accredited Institution: *

Degree, Training or Certification: *

Year Received: *

Additional Education/Training/Certification (if applicable):

Name of School, College, University or Accredited Institution:

Degree, Training or Certification:

Year Received:

Additional Education/Training/Certification (if applicable):

Name of School, College, University or Accredited Institution:

Degree, Training or Certification:

Year Received:

Awards/Special Achievements

List accomplishment(s) and date(s):(500 Character Word Limit)

Qualifications

Have you served on a City of Hayward Board, Commission, Committee or Task Force? * Yes No

If yes, please give the name(s) and date(s) served:

Explain why you want to be appointed to a City of Hayward Commission or Task Force and what are your goals if selected: (500 Character Word Limit) *

Briefly provide information on any additional experience you believe supports your qualifications for an appointment to a City of Hayward Commission or Task Force: (500 Character Word Limit) *

Please indicate below how you found out about these opportunities? *

If 'Other' please specify

Upload a Resume
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Please review the statement below and check the acknowledgement box: *

I have sufficient time to devote to this responsibility and will attend the required meetings, and will complete the required Ethics and Harassment Prevention trainings if I am appointed. I understand that service on certain Commissions may require filings of the Fair Political Practices Commission - Statements of Economic Interests (Form 700). If appointed, I will file the necessary disclosure documents.

I Agree *