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CITY OF CUPERTINO
APPLICATION FOR ADVISORY APPOINTMENT
Please fill out all the required fields. Otherwise, you would not be able to
submit the form.
Last Name:
First Name:
Middle Name:
Address:
City:
State:
Zip Code:
Phone Numbers in (xxx) xxx-xxxx format:
Home Phone:
Business Phone:
E-mail:
How long have you been a resident of the City of Cupertino?
Occupation:
Education (Select highest year completed):
Professional Licenses or Registrations:
On which Advisory Commissions, Committees, or Boards would you like to
serve? (List in order of preference. List no more than two):
What public office or offices do you currently hold?
Please list your qualifications for this position:
Are there any special interests or activities that you wish to bring to the
attention of the City Council? (These need not be directly related to the
appointment that you are seeking.)
Do you have any obligations that might affect your regular attendance at
scheduled evening meetings?
The space below is provided for any additional comments that you may wish to
make about yourself or the position being sought.
If you are not selected at this time, we will keep your application on file
for a one (1) year period for consideration should a commission
vacancy occur.
I certify that I am not an official or employee of the City of Cupertino, nor
related by blood or marriage to any official or employee of the City of
Cupertino.
Note: Please fill out all the required fields. Otherwise, you
would not be able to submit the form.
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