HCNC Candidate Application Form
APPLICATION DEADLINE: All candidates wishing to fill a vacancy on the HCNC Board of Directors must complete and submit this form by the deadline printed on the public notice of the "Call for Candidates" for the vacant seat. Any applications and documentation received after this date will not be processed.

This form may be submitted online or by mail. To apply by mail, please send the completed form and the required eligibility documents to:

Attn: Third Vice President/Historic Cultural Neighborhood Council, c/o Koban, 307 E 1st St, Los Angeles, CA 90012.

DISCLAIMER: The HCNC will not be responsible for any mail that is late or lost.

For more information or clarification regarding this form and acceptable forms of documentation, please contact hcncla@gmail.com

Thank you for you submission. Failure to provide accurate or complete information will result in your application being denied.

First Name *
Your answer
Last Name *
Your answer
Email Address *
If you do not have an email address, please type NA
Your answer
Phone Number *
Your answer
Name as you would like it to appear on the ballot
(if different)
Your answer
Home Address
If you are applying for a residential seat - Must reside within the boundaries
Your answer
Mailing Address
If different from Home Address - Must reside in the HCNC boundaries
Your answer
What type of seat do you wish to fill? *
Select only one - Multiple selections will result in the application being kicked out
Stakeholder Categories *
Select only one
Residence Address
(Required if "RESIDENT" is checked.)
Your answer
Name of Business or Place of Work
(Required if "BUSINESS OR EMPLOYEE" is checked.)
Your answer
Physical Address of Business
(Required if "BUSINESS OR EMPLOYEE" is checked) Must reside within the HCNC boundaries
Your answer
Property Address
(Required if "PROPERTY OWNER" is checked.) Must reside within the HCNC boundaries
Your answer
NON-PROFT Special Instructions
Non-Profits must either have a permanent physical address that is noticed either on formation document, ie; the IRS or Secretary of State OR can show their continued residency via utility bill or similar document that they have an established and ongoing operation at one single location in one single community within the HCNC Boundary. The non profit must have a current active status with the SOS.
Nonprofit Organization Address
(Required if "NONPROFIT" is checked.)
Your answer
Provide documentation to establish your eligibility as a stakeholder for the Board Seat. At least one document from each category must be provided. At least ONE document must show both your name and an address within the HCNC boundaries. If you are applying for a neighborhood-specific seat (Arts District, Chinatown, El Pueblo, Little Tokyo, Solano Canyon, Victor Heights), you must provide the appropriate type of documentation that includes both your name and address within those neighborhood boundaries as defined in the HCNC Bylaws.
Document 1 - Photo ID *
Please make a copy and redact your ID number. The photo is used to prove you are you. Select only one.
Document 2 Supporting documentation *
The second document is required for the board seat that you are seeking and must show both your name and address within the appropriate neighborhood boundaries. Please remember to redact you account number or private personal information. The only exception is an SOS filing. You may include mutiple documents from this category to help support your candidacy. Exception is NON-Profit which needs to provide 2 items from section 2 as indicated.
You may submit your resume and/or a brief statement about yourself and your interest in serving on the Board.
Enter resume here
Your answer
Enter statement here
Your answer
I will submit my resume and/or statement by *
All documentation and submissions must be received by the candidate deadline posted on the call for candidate notice.
I declare under penalty of perjury that the above statements are true and correct. *
(Sign or type your full name here as your signature.)
Your answer
Date *
Your answer
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