Reynolds, J. Dean e"E""k City of Anaheim
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11 _, : -._:. > APPLICATION FOR APPOINTMENT JAN — 5 2023
__ CITY COUNCIL DISTRICT 4
Fo` r`- t CITY OF ANAHEIM
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OFFICE OF THE CITY CLERK
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The City of Anaheim is accepting applications to fill a District 4 City Council seat vacancy for a term ending November
2024.Pursuant to Section 501 of the Charter,interested candidates must be a resident and qualified elector of District 4
at the time of and for the thirty(30)days immediately preceding appointment.
DUE DATE:Applications are due to the Office of the City Clerk by Wednesday,Jan. 18,2023 at 5:00 P.M. (Postmarks not
acceptable) Submit to: Office of the City Clerk, City of Anaheim, 200 S.Anaheim Blvd., Ste. 217 Anaheim, CA 92805;
Email:cityclerk@anaheim.net Fax:(714)765-4105
Note:This application is considered public information and will be released to the public,including being posted to the
City's website.
Applicant Information
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Address: City: State: Zip Code:
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E-Mail: Phone Number: Alternate Phone Number:
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Years lived in District 4,City of Anaheim: Years lived/worked in City of Anaheim:
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Professional and Educational background(may submit Resume):
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Office of the City Clerk•200 S.Anaheim Blvd.,Suite 217,Anaheim, CA 92805•(714) 765-5166
Name:
List any City of Anaheim,County,and or other Board/Commissions and/or organizations on which you have
served(professional,technical,community,service):
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Reasons why you are interested in serving.State your interest in the position,qualifications,skills,or experience
that can best serve the residents of District 4 and the City of Anaheim(separate attachment may be included):
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Office of the City Clerk•200 S.Anaheim Blvd.,Suite 217,Anaheim, C4 92805•(714) 765-5166
Name:
What do you see as the top issues facing District 4 and the City of Anaheim?(Separate attachment may
be included):
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What are your priorities for District 4 and the City of Anaheim?(Separate attachment may be included):
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Pursuant to Section 501 of the Charter,I am and have been a resident and qualified elector of District 4 at the
time of and for the thirty(30)days immediately preceding possible appointment to office. I declare under
penalty of perjury under the laws of the State of California that the information contained herein is true and
o accurate to the best of my knowledge.
I acknowledge that the City has the right to verify the truth and accuracy of all information submitted and that
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w this is a public document.
ure: Date:
1 3 2 3
Office of the City Clerk•200 S.Anaheim Blvd.,Suite 217,Anaheim. C4 92805•(714) 765-5166