Diana Herrera RECElinD
CITY OF ROSEMEAD
DEC 2 _ 1998
CITY OF ROSEMEAD1 ¢�(�
APPLICATION FOR TRAFFIC PLANNING ✓ COMMISSION IN CLERKSOFFICFs,
Please print� /•ortype: T y',�I /�1rfp1�/�
NAME: 17)31? -79•
i u_VI a �/''/.� I I e I CY a. Q C
ADDRESS: 3 b ( -1 • N• .Pe/� J4Ve • / 1 oSen,ge
RESIDENCE TELEPHONE:)Z 1'—Sl3o BUSINESS TELEPHONE/3)223-7-94256
MALE: FEMALE:
ARE YOU A REGISTERED VOTER IN THE CITY O'jFROS1EMEAD? ies
HOW LONG HAVE YOU LIVED IN CALIFORNIA? 3-l((��?g,,S.ROSEMEAD? 3E7 Yrs.
EMPLOYER'S NAME: `old QWellAnker Real LE-s127-/-e-
BUSINESS
'S faBUSINESS ADDRESS: ! -D Las ho✓ias br. /enple C'ft
TYPE OF BUSINESS: ?ea / /�++
OUTSIDE BUSINESS INTERESTS:_11)14(g113 " fixers " (howesl "7a
{iX P resale .
EDUCATION NAME & ADDRESS OF SCHOOL NO. YRS YEAR
ATTENDED GRADUATED
Grammar School Mildred I3• sansavl
High School QD5 elm Pa c( fj-i45k
College or Univ. 5iMtCCP un 4S 4vdsc.
Night School or orf Quo sysdo .' PCC.
Corres. School nn__
PROFESSIONAL AND BUSINESS ASSOCIATIONS: KFSeui,a /`4 ( ber of Cethagefeet
Qoseatrl I-�igk PTf} i Ja ltsoh IOTA I Wes* can gabs-fel Ascot oPRetclrws
ARE YOU DISQUALIFIED TO VOTE IN THE STATE OF CALIFORNIA, COUNTY OF LOS
ANGELES, DUE TO A FELONY CONVICTION? mt.
I AM PRIMARILY INTERESTED IN SERVING ON THE PLANNING COMMISSION
(Meets the first and third Monday at 7 : 00 p.m. )
I AM PRIMARILY INTERESTED IN SERVING ON THE TRAFFIC COMMISSION
(Meets the first Thursday at 7: 00 p.m. )
PERSONAL OR BUSINESS ACTIVITIES THAT WOULD BE IN CONFLICT WITH YOUR
SERVING AS A COMMISSIONER:
ADDITIONAL INFORMATION YOU FEEL WOULD BE HELPFUL TO THE COUNCIL IN
MAKING ITS DECISION:
7 -Peel L Wort/sI be an aSSef , irr, coma/1-65/s,
due ,lo wit ✓✓O(wst fcer i k nplfre+lt ewi- i Self i n >2O5a4ledte.
DATED: /2- /6-9F /J "
Applicant Si at r
Note: This questionnaire will be kept on file for consideration by
the Council in future Commission appointments.
E.41: 12