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HomeMy WebLinkAboutApplication from Ian Greene for IHSS Advisory Committee Menchaca, Clarissa From: Menchaca, Clarissa Sent: Wednesday, October 17, 2018 4:55 PM To: SOS Cc: Boston, Shelby; Ramirez, Mariann Subject: IHSS Advisory Committee Application Attachments: Greene.pdf Good evening— Please see the attached application from Ian Greene for the IHSS Advisory Committee. acte144-004• II Associate Clerk of the Board Butte County Administration 25 County Center Drive, Suite 200, OrovilIe, CA 95965 T: 530.552.33081 F: 530.538.7120 Twitter I Facebook I YouTube I Pinterest `u�ati.;f; County of Butte :: APPLICATION FOR APPOINTMENT TO BOARDS, COMMITTEES, OR COMMISSIONS Butte County •CALIFORNIA INSTRUCTIONS:Please complete this form in its entirety. Be sure to include the full title of the Board, Committee or Commission for which you request consideration. *Please note that this application is a public document and is subject to the California Public Records Act(CA Gov. Code §6250-6270). Board, Committee or Commission you wish to be appointed to: IHSS Advisory Committee Seat Name(if applicable): Supervisorial District you live in: District 1 El NAME: Greene Ian Joseph (Last) (First) (Middle/Initial) ADDRESS: 200 Table Mountain Blvd #6 Oroville CA 95965 (Street) (City) (State) (Zip Code) MAILING ADDRESS (if different from Home address): HOME PHONE: (530)538-1268 WORK PHONE: OTHER: EMAIL ADDRESS: bruceleeismyuncle@yahoo.com OCCUPATION: IHSS Care Provider/U.D.W Butte County Union Rep EDUCATION: Check appropriate box: ■❑ High School Diploma ❑GED/CA High School Proficiency Certificate ❑College Name of College/University Course of Study/Major Degree Awarded 1 Academy Of Art San Francisco I Fine Art/Illustration 1 None I 0 Please provide any additional college/university/schools/training completed on a separate page. EXPERIENCE: Other County Boards, Committees or Commissions on which you have served: I f v' ✓ LC•.r3Cs GPY0"; c. 0m : S _MAA EXPERIENCE continued: Additional applicable community experience and affiliations: Delegate at the Nothern California Labor Federation Other experience you feel would be helpful to the Board of Supervisors in making this appointment: Hopefully being a care provider and union rep should suffice. REFERENCES: Please provide three(3) references with telephone numbers 1. Dwane Camp (415) 305-1481 2. Dr, William Reed (916) 396-6601 3. Kesha Haynie (530) 680-1661 *Members of boards, commissions, and committees may be required to:1)file a Statement of Economic Interest Form also known as a Form 700, and 2)complete the State Ethics Training Course as required by AB 1234. *Members may be required to take the following training:1) The Brown Act,2) The Better Government Ordinance, and 3)Ethics Training. *You may submit a résumé, letter of interest, and/or additional materials with this application. *If you have any questions concerning the application process, a letter of interest or a specific appointment, you may contact the Clerk of the Board at 530-552-3300. Submit the completed application to the.Clerk of the Board of Supervisors, 25 County Center Drive, Suite 200, Oroville CA 95965, or via e-mail at clerkoftheboard@buttecounty.net.