Tract 2964 application

This application is to fill one vacant BUSINESS REPRESENTATIVE seat for the term ending June 30, 2021. Candidates must own or work at a licensed business doing business within the boundaries of the NWSPNC OR reside within the boundaries of the NWSPNC and own or work at a business that is a member of the San Pedro Chamber of Commerce. A map of the Northwest San Pedro Council boundaries can be found at http://nwsanpedro.org/wp-content/uploads/2015/07/DONE-Northwest-San-Pedro-Neighborhood-Council-Map.pdf

Review this document: What it means to be a neighborhood council board member.

I hereby acknowledge that I have read the above document and understand the duties and responsibilities of being a board member.

Type your Name here.

Ready to apply? Fill out the form below.

Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number (Day)

Area Code Phone Number

Phone Number (Evening or Cell)

Area Code Phone Number

Email

example@example.com

Name of Business:

Address of Business:

Do you own this Business?

Documentation: All candidates shall be required to provide the appropriate documentation. Documentation must include photo identification and one item from the appropriate category/categories.

Business Owner: business tax registration certificate and a)either proof of business address within NWSPNC, b)certification that they conduct substantial business within the boundaries of the NWSPNC, or c) evidence that they reside within the boundaries of the NWSPNC and proof of the businesses' membership in the San Pedro Chamber of Commerce.

Employee: Employment records, W2 forms, wage payment stub with name and address of employer, worker ID, letter from employer on business letterhead, and/or proof of residency and businesses' membership in the San Pedro Chamber of Commerce.

Business Representative Document (Click below to upload)

Photo ID (Click below to upload)

Date

I hereby certify under penalty of perjury, that I am at least 16 years of age and the information above is true and accurate.

Type your Name here.

This application must be submitted NO LATER THAN TUESDAY, MARCH 3, 2020.

If you have any questions, contact us at:
board@nwsanpedro.org or 310-918-8650

Board Candidate Application - Business Seat