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CITY OF NATIONAL CITY APPLICATION FOR APPOINTMENT TO CITY BOARDS, COMMISSIONS, AND COMMITTEES Civil Service Commission Planning Commission Community & Police Relations Commission* (CPRC) Public Art, . Library Board of Trustees Traffic Saf� Ght�tee L Parks, Recreation & Senior Citizens Advisory Board CI E ,iA Note: Applicants must be residents of the City of National City exail ailoanlikabyla, Applicants for the Community and Police Relations Commis&idri'ii6s$I1n10141Y background check prior to appointment. Name: (9t OG. 00 CRUD Y) / Z L &D Home Address: 3) 3 ( f AVE_ Business Affiliation: Title: Tel. No.: %l y ' 7?— (03 Z, Business Address: Tel. No.: /J Length of Residence in National City: Z-2 San Diego rCounty: J y,&alifornia: 7y2, Educational Background: ez Y+I P 1 `L�ri_t) `?viz. A'pPf cr/1c i2)1?p J©DL N114. SOC.(7 !45)/-lv(.G��.G dk/V. ZVAt, Occupation I Experience: ZC/y,e-, /AI 1�j ©,5",4c E, eiutt„1 ft .i /r—L)/ bg-U' d/Op ,,a7 7 f—/ 4 T O-rC no-2-42seiricE Professional or Technical Organization Memberships: Sew/67 8 F >) Ci 'c or Community Experience, Membership, or Previous Public Service Appointments: tUi: A e 6- ten ni 11 Experience or Special Knowledge Pertaining to Area of Interest: Have you ever been convicted of a felony crime? Noes:_ misdemeanor crime? No:_ Yes:_ If any convictions were expunged disclosure is not required. Convictions are not necessarily disqualifying. Please feel free to provide an explanation or information regarding yes answers to the above two questions. Date: /T Signature: / • Please feel free to provide additional information or letters of endorsement. Please return completed form to: Office of the City Clerk 1243 National City Blvd, National City, CA 91950 Thank you for your interest in serving the City of National City. * Residency requirements may not apply This documents is filed as a public document Revised: March 2012 Supplemental Application: National City Community and Police Relations Commission The National City Community and Police Relations Commission serves as an independent, unbiased and impartial office that is readily available to the public. It is an organization for the improvement of police and community relations and the facilitation of disputes whenever possible. It provides a forum for citizens to voice their concerns, comment about police conduct, practices and policies and improves communication between citizens and the National City Police Department The National City Community and Police Relations Commission is empowered to receive and review complaints regarding National City Police Department Personnel for alleged misconduct, and to recommend appropriate changes of Police Department policies and procedures toward the goals of safeguarding the rights of persons and promoting higher standards of competency, efficiency and justice in the provision of community policing services. Applicants must be completely forthright and truthful during the application process. Applicants may be disqualified in the background process as a result of dishonesty and/or purposely omitting information regarding one's criminal history. Given the complexity of this Commission and its duties, it is necessary to pass a criminal background check prior to appointment by City Council and/or swearing in as Commissioner. The Human Resources department will contact you to schedule the criminal background process when, and if appropriate. It is important to note that you fill out this application completely and honestly to the best of your abilities. Failure to disclose your criminal history may result in disqualification. If a conviction has been expunged disclosure is not required. Have you ever been convicted of a felony crime: No: >( Yes: Have you been convicted of a misdemeanor: No: Yes: �c If any convictions were expunged disclosure is not required. Please feel free to provide an explanation or information regarding yes answers to the above two questions. DU llyiz 1.10 There may be circumstances that could disqualify an applicant from the background process beyond the listed crimes below. Each incident is evaluated in terms of the circumstances and facts surrounding its occurrence and its degree of relevance to the position. Disqualifying criteria for Community and Police Relations Commissioner: **See attached table Disqualifying Criteria for National City Community and Police Relations Commission Felonies Lifetime 20 Years 15 years 10 years 5 years Crimes against Persons *including but not limited to Assault & Battery x Domestic Violence x Elder/Child Abuse x Manslaughter x Murder x Sexual Acts w/ Minor x Rape x Crimes against Property *including but not limited to Arson x Burglary x Embezzlement x Extortion x Fraud x Forgery & Counterfeiting x Possession of stolen property x Theft x Crimes involving Drugs *including but not limited to Illegal Drug Use x Possession or Sales x Production of Drugs x Crimes against Public Justice Bribery & Corruption x Impersonating a Peace Officer x Misdemeanors Lifetime 20 years 15 10 years 5 years years Crimes of Moral Turpitude *including but not limited to Burglary x Embezzlement x Forgery x Fraud x Possession of stolen property x Theft x Crimes involving Drugs or Alcohol *including but not limited to Lifetime 20 years 15 years 10 nears 5 years Disorderly Conduct x Under the Influence x Unlawful Possession x Crimes against Persons *including but not limited to Assault & Battery x Manslaughter x 3