Thank you for your interest in serving on the Measure P Oversight Committee. 

Please complete the form below and click the "Submit" button at the bottom of the page.  Someone from the City Manager's office will be in touch.

1

List the stakeholder group you wish to represent:

List the stakeholder group you wish to represent:

Resident Member in Leadership of Local Major Retail Industry

Resident Member in Leadership of Clergy

Resident Member of Non-Profit Social Services Provider

As indicated above, the Leadership role shall be defined as an individual serving in an executive capacity or a board member capacity. In no event shall a committee member be a City of Victorville staff member.

2

Name:

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Name:

3

Address:

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Address:

4

Telephone Number:

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Telephone Number:ext.

5

Email Address:

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Email Address:

6

Occupation:

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Occupation:

7

Employer:

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Employer:

8

Why do you think you are qualified to be a Committee member?

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Why do you think you are qualified to be a Committee member?

9

State your educational background.

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State your educational background.

10

Please list Boards and Committees that you serve on or have served on.

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Please list Boards and Committees that you serve on or have served on.

11

Do you agree with consensus decision making?  Please explain your response. 

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Do you agree with consensus decision making? Please explain your response.

12

Are you willing to attend regularly scheduled meetings of the Oversight Committee?

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Are you willing to attend regularly scheduled meetings of the Oversight Committee?

13

Do you anticipate having any conflicts of interest that may disqualify you in making decisions, due to personal and/or business relationships?

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Do you anticipate having any conflicts of interest that may disqualify you in making decisions, due to personal and/or business relationships?

14

List any private and non-profit affiliations.

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List any private and non-profit affiliations.

15

List all other pertinent information/background for this position.

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List all other pertinent information/background for this position.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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