APPLICATION FOR INDEPENDENT CITIZENS’ OVERSIGHT COMMITTEE
This form must be submitted by 4:30 PM on April 26, 2019.
Name (Last, First) *
Your answer
Address *
Your answer
Phone Number(s) *
Please indicate home, cell, work, etc.
Your answer
Email Address *
Your answer
Why do you want to serve on the Measure W and Measure T Independent Citizens’ Oversight Committee? *
Your answer
Do you have any special area of expertise or experience that you think would be helpful to the committee? *
Your answer
If you have served on other school district, city or community committees please list and briefly describe your role. *
Your answer
I would be able to represent the following constituencies in the District *
Check all that apply
Required
For selection(s) that include (1) Business Representative, (2) Senior Citizen Group Representative or (3) Taxpayer Organization Member, please list the name of the organization(s) that apply.
Your answer
For selection(s) that include (4) Parent or Guardian of Child Enrolled in District, please list the name of your child(ren) and school(s) attended.
Your answer
For selection(s) that include (5) Parent or Guardian of Child Enrolled in District AND active in a Parent-Teacher Organization, please list the name of your child(ren) and school(s) attended AND the organization(s) that apply.
Your answer
Please note any additional information you feel should be considered as part of your application.
Your answer
Are you an employee of the District? *
*Employees, vendors, contractors, and consultants of the Perris Union High School District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.
Are you a vendor, contractor, or consultant to the school district? *
*Employees, vendors, contractors, and consultants of the Perris Union High School District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.
Do you have conflicts that would preclude your attending quarterly meetings? *
Do you know of any reason, such as a potential conflict of interest, which would adversely affect your ability to serve on the Independent Citizens’ Oversight Committee? *
*Employees, vendors, contractors, and consultants of the Perris Union High School District are prohibited by law from being members of the Citizens’ Oversight Committee. Employment which could result in becoming a contractor or subcontractor to the district would also be a potential conflict.
Are you willing to comply with the ethics code included in the bylaws? *
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