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Connect San Anselmo
Youth Commissioner Application 2022/23
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YOUTH COMMISSIONER APPLICATION - 2018/19
Please select which Committee you are applying for:
Bicycle and Pedestrian Advisory Committee
Library Advisory Board
Open Space Committee
Parks & Recreation Committee
Quality of Life Commission
If you are applying for more than one Committee please list in order of preference.
Grade in Fall 2018:
Parent or Guardian:
Please list any organized activities that you have participated in:
Please tell us why you wish to apply for this appointment:
Please tell us how you think you can help the Commission/Committee improve:
Please tell us what you think are the most important issues facing the Commission/Committee:
Name and phone numbers of three San Anselmo residents who can be contacted for referral information:
I would be able to attend monthly meetings of this Commission:
I would be able to serve for a period of one year:
I am familiar with the responsibilities & functions of this Commission:
You may attach personal documents that you believe will be helpful to the Commission/Committee in making its selction process:
Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)
Thank you for your interest in serving the Town of San Anselmo and its citizens. For further information, please contact the Town Clerk, Serge Avila, at 415-258-4660 or email@example.com.
Application must be returned to Town Hall no later than April 26, 2018
* indicates required fields.
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