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GOEBEL SENIOR CENTER COMMISSION �Oile70 <br />1385 E. Janss Road, Thousand Oaks, 91.362 • (805) 381-2744 • F (805) 495-5430 W J <br />Reoeaamn & Park Olsbid <br />COMMISSIONER AEPLICATXON <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 indude Thousand Oaks, Newbury Park, and the Ventura County section of Westlake Village <br />Full Name: —r ' r3 i 'e <br />Today's Date: , A-1 <br />Address:,'' C-1. <br />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 />i co <br />i _ <br />r <br />Why are you interested in becoming a member of the Goebel Senior Center Commission? <br />How would your appointment be beneficial to the Goebel Senior Center Commission? <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 />'✓�''d l`--�"-- .��l u . i J You may include additional pages for <br />*plicant Signature bate -Signed your responses or other attachments. <br />Applications may be sent to ^ or delivered to the Goebel Adult Community Center at 1385 E. 7anss Road, Thousand Oaks, CA 91362, <br />GSCC Commissioner Application Revised 01.2019 <br />P13 <br />