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TO: BOARD OF SUPERVISORS ;•,% < = Costa
FROM: Supervisor Jose ph Canciamilla ��„ae County
ST'4'COiI� .
DATE: June 3, 1997
SUBJECT: APPOINTMENT TO THE MENTAL HEALTH COMMISSION
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)AND JUSTIFICATION
RECOMMENDED ACTION: Appoint the following individual to the Mental Health Commission as the
District V At-Large representative, with a term to expire June 30, 1999.
Lynn Gurko
4640 Deer Meadow Way
Antioch, CA 94509 .
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR. CO M DATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON June 3 , 1997 APPROVED AS RECOMMENDED: X OTHER:
VOTE OF SUPERVISORS:
X UNANIMOUS(ABSENT — — — — )
AYES: NOES:
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY
OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF
ABSENT: ABSTAIN: THE BOARD OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED.
cc: Supervisor Joseph Canciamilla June 3 , 1997
Ms.Lynn Gurko-via District V PHIL BATCHELOR,CLERK OF THE BOARD OF
Christina Koch-Health Services Dept. UPERVISORS AND OUNTY ADMINISTRATOR
BY
DEPUTY
M ,_2f:advisory board applying for, _ �1 Ul T e,
Application Form must be
or hand rinted.
PP tYF� P
.Name of Applicant:
Home Address: . (p () ��,�, �,�,dow W'� Home Phone:C5�b�"'1�j'�-,^ D��
ti� CA °I�5
Business Address.. �� G� � Work Phone: •�
Signature: - Date: a— —Cq
Personal Experience, Skills and Interests
Education/Background:
Occupation (student, for.pay work,' not for pay W`0' rk, retiree or similar):
Community Ac ivides:
Special In erests: "
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Information:
1. File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA
94553.
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public
transportation.
4. Meetings may be held either in the evenings or during the dav, usually once or twice a month.
5. Some boards assign members to subcommittees or work groups requiring additional time.