James Wang Rt-LL
CITY CF POSERCAD
CITY OF ROSEMEAD
APPLICATION FOR TRAFFIC ✓ PLANNING COMMISSIOX[p.'m' CLERK'SOFFICE
Please print or type:
NAME: c1 tt fr c--g
ADDRESS: 2r >1- s . OaRvLY /-}v.7 2I #ecSe:,.zA-r7 CA- 977u
RESIDENCE TELEPHONE: GAG )S7( - ftC? BUSINESS TELEPHONE (e.>01-7(- 22,1
MALE: FEMALE:
ARE YOU A REGISTERED VOTER IN THE CITY OF ROSEMEAD?
HOW LONG HAVE YOU LIVED IN CALIFORNIA? /j yr ROSEMEAD? cL y Y
EMPLOYER'S NAME: - / - o
BUSINESS ADDRESS: 7tJCi �fp2�a-r /.Fv7 y�. R 1 tHL'&
TYPE OF BUSINESS: ace p r
OUTSIDE BUSINESS INTERESTS:
EDUCATION NAME & ADDRESS OF SCHOOL NO. YRS YEAR
ATTENDED GRADUATED
Grammar School
High School
College or Univ. CL U4,o Fra e,/ ca i✓. ✓ //yr.
Night School or
Corres. School
PROFESSIONAL AND BUSINESS ASSOCIATIONS:
Crr,Nesse, y7-nit.?, C/ N Au- o .F-c z- ce. 7,
ARE YOU DISQUALIFIED TO VOTE IN THE STATE OF CALIFORNIA, COUNTY OF LOS
ANGELES, DUE TO A FELONY CONVICTION? Gin
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 ACTIVITIESI THAT WOULD BE IN CONFLICT WITH YOUR
SERVING AS A COMMISSIONER: nln
ADDITIONAL INFORMATION YOU FEEL WOULD BE HELPFUL TO THE COUNCIL IN
MAKING ITS DECISION:
DATED: / 'v
Applica Signatur
Note: This questionnaire will be kept on file for consideration by
the Council in future Commission appointments.
E.41: 12