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GOEBEL SENIOR CENTER COMMISSION 4f lift <br />WlConejo <br />1385 E. Janss Road, Thousand Oaks, 91362 • (805) 381-2744 • F (805) 495-5430 <br />Recreation a Park District <br />COMMISSIONER APPLICATION <br />The Goebel Senior Center Commission is a nonprofit community service organization. Commissioner requirements include: <br />• Applicants must be at least 50 years of age <br />• Applicants must reside within the boundaries of the Conejo Recreation & Park District* <br />• Applicants must be able to commit to a minimum of 15 volunteer hours each month <br />• Applicants must be able to commit to assisting at a minimum of three Special Events annually <br />* CRPD Boundaries include Thousand Oaks, Newbury Park, and the Ventura County section of Westlake Village <br />Full Name: .Sandy Barry <br />Address: <br />Today's Date: 2-23-19 <br />Thousand Oaks CA 91360 <br />V( Yes, I live within the boundaries of the Conejo Recreation & Park District (as outlined above). <br />Cell Phone: Work Phone: <br />E -Mail Address: <br />Describe your work and/or volunteer experience relevant to the work of the Goebel Senior Center Commission. <br />Have been a commissioner for past 3 years. On Board of Directors for my HOA. Volunteer for <br />seniors at nursing homes and assisted care facilities. <br />Why are you interested in becoming a member of the Goebel Senior Center Commission? <br />Have enjoyed past 3 years as Commissioner. Like volunteering for Bingo and the entertainment <br />programs provided by commission and center. <br />How would your appointment be beneficial to the Goebel Senior Center Commission? <br />I like working with fellow Commissioners to provide programs and assistance to Goebel Center. <br />I hereby certify that the above information is accurate to the best of my knowledge and also hereby acknowledge that <br />intentionally providing false or misleading information on this application will disqualify me from becoming a commissioner. <br />Notice to Applicant: <br />2-23-19 �' <br />You may include additional pages for <br />Applicant Si ture Date Signed your responses or other attachments. <br />Applications may be sent to mbraff 2crpd.orq or delivered to the Goebel Adult Community Center at 1385 E. Janss Road, Thousand Oaks, CA 91362. <br />GSCC Commissioner Application Page 1 of 1 Revised 01.2019 <br />