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HomeMy WebLinkAboutAttachment 5 - Jason Devor Application From: noreolv(cacivicOus.com To: CiW Clerk Subject: [External]Online Form Submittal:Commission/Committee Application Date: Monday,November 25,2024 6:43:07 PM Fes7sa7ge from external sender. Use Caution. Commission / Committee Application The City currently has two active Commissions/Committees: the Planning Commission and the Measure Z Citizen Committee. All commissions/committees consist of five members who shall not be officials or employees of the City. Applicants for the Planning Commission shall legally reside within the City limits or be the owner of a business that is established and currently licensed within the City limits (LEMC Section 2.24.020). Applicants for the Measure Z Citizen Committee must legally reside within the City limits. Each commission/committee serves as an advisory body to the City Council on policy matters or reviewing specific issues as directed by the City Council or prescribed by law. Currently, all Planning Commissioners are appointed at-large by a City Council Subcommittee. However, members of the Measure Z Citizen Committee are appointed by district by their elected council representative. Instructions Please answer each question completely. This application will be maintained until December 31st of each year. After December 31st, it is necessary to file a new application for another year of eligibility. Please be advised that the City Clerk's Department uses Voter Registration information for verification of residency. Note: This application is subject to the Public Records Act and may be released to the public. Additional Resources to Assist in Completing Application • View a map showing the City limits (PDFJ. • Find out which City Council District you live in. (Section Break) Commission / Committee Planning Commission Applying For Applicant Eligibility City Resident, Business Owner (Section Break) Applicant Information First Name Jason Last Name Devor Address City Lake Elsinore State CA Zip Code 92530 Phone Number - Email Address Length of Residency in 10 years Lake Elsinore Length in California 36 years What City Council 4 District do you live in? 'Section Break) Business Information (if Applicable) Business Name Field not completed. Business Type Field not completed. Business Address Field not completed. Lake Elsinore Business Field not completed. License Number Expiration Date Field not completed. Phone Number Field not completed. Date Business Field not completed. Established (Section Break) Education Information Name of School None Attended City & State Nw Degree Earned Nome Number of Units Field not completed. Completed Name of School Field not completed. Attended City & State Field not completed. Degree Earned Field not completed. Number of Units Field not completed. Completed Certificates Attained Field not completed. (Section Break) Do you have Economic Yes Interests, such as income, investments, real or personal property, or outstanding loans which might present a potential conflict of interest? (Section Break) Work History Current Employer Hit Print Address Dates Worked 12/31/2020 Position CEO Duties Performed Field not completed. Previous Employer Field not completed. Address Field not completed. Dates Worked Field not completed. Position Field not completed. Duties Performed Field not completed. (Section Break) References Preferably local residents or stakeholders who are qualified to comment on your capabilities Name Ken Devor Address Phone Number - Name Shaun Brock Address Field not completed. Phone Number - Name Mike Norkin Address Field not completed. Phone Number (Section Break) Community Service Participation Please describe types of service you have performed, if any. Organization Cops 4 kids Types of Service On board of directors Organization LEGS softball Types of Service Coach Organization Field not completed. Types of Service Field not completed. Additional Field not completed. Documentation (Section Break) Are you an Officer or No Member of a policy- making board of a non- profit organization which receives funding from the City? If Yes, please list all organizations. Organization Field not completed. Position Field not completed. Organization Field not completed. Position Field not completed. Organization Field not completed. Position Field not completed. Additional Information Field not completed. (Section Break) Have you ever been No convicted of violating any Federal, State, County or Municipal law, regulation or Ordinance, excluding minor traffic violations? If Yes, please explain. Field not completed. (Section Break Why are you interested I love this city and look to further my involvement to see its in serving on this successful growth. I have hosted and organized a multitude of Commission/Committee? free community events just to give back. This would be a wonderful opportunity to serve the community in a more official capacity. Please list any I own and operate 2 successful businesses with experience in qualifications you may budgeting, operations and negotiations. I also have deep ties to have to serve on the the business community. Commission/Committee you are applying for, i.e. education, related service or work experience, budgeting or financial experience, community involvement, etc. (Section Break) Please note Appointees will be required to take an Oath of Office and file a completed Statement of Economic Interest form, if appointed to a position specified in the City's Conflict of Interest Code. Appointees are not considered to be City employees for purposes of benefits, such as workers compensation and health insurance. Applicant's Declaration and Signature I certify under penalty of the perjury laws of the State of California that all information on this form is true and correct. By typing my name and the date completed on this form, I am affirming my intent to be a candidate for appointment to a Commission for the City of Lake Elsinore. if appointed I pledge to follow the laws of the City of Lake Elsinore, the policies as set forth by the City Council and to conduct myself in such a manner as to be a good representative of the City. Signature (Please type Jason Devor your name) Date 11/25/2024 Email not displaying correctly?View it in your browser.