Candidate Application Form

To apply as a candidate for a vacant seat, please complete all questions. The board will appoint a candidate for the seat at the next Regular Board Meeting. Please visit the website for location and agenda. The meeting is called to order at 6:30pm.

All applications must be received by 12:00 midnight on Monday, February 10, 2025 and candidates must attend the meeting in order to be appointed. Candidates must provide documentation and any other applicable identification to establish their stakeholder status. For more information regarding this form and acceptable forms of documentation, send email to info@centralsanpedro.org.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email

example@example.com

Stakeholder Status

I am a resident within the neighborhood council boundaries at the address above.I own within the neighborhood council boundaries at the address below.I work within the neighborhood council boundaries at the address below.I am a community interest stakeholder within the neighborhood council boundaries (A Community Interest Stakeholder is one who declares a stake in the neighborhood and is defined as aperson who affirms a substantial and ongoing participation within the Neighborhood Council’sboundaries and who may be in a community organization such as, but not limited to, education, nonprofit and/or religious.)

Name as it should appear on the ballot.

First NameLast Name

Enter the address and/or name of the organization/place of employment which qualifies you as a Stakeholder.

Candidate Statement (tell us why you would like to run for a board seat). (100 words or less)

Upload a photo to be included with your candidate statement

Two forms of documentation confirming stakeholder status are required per the CeSPNC bylaws. Upload Document #1 to prove your eligibility as a stakeholder (example: driver's license, passport, etc.)

Upload Document #2 to prove your eligibility as a stakeholder (example: utility bill, letter from organization, etc.)

Electronic Signature (Type your name here)

Signature Date

Date