Before applying, please visit the following webpage to review the requirements for the specific advisory committee you're applying for: San Francisco County Transportation Authority Citizens Advisory Committee (TA CAC) Please select the advisory committee you're applying for: * Transportation Authority CAC First Name * Last Name * Gender (Optional) - -MaleFemaleNot Provided Ethnicity (Optional) - -AsianAfrican AmericanAmerican Indian or Alaska NativeCaucasianHispanic or LatinoNative Hawaiian or Other Pacific IslanderNot Provided Supervisorial District of Residence * - -1234567891011 Neighborhood of Residence * Home Address * Home Address - City * Home Address - State * Home Address - Zip Code * Home Phone Number * Home Email Address * The following questions regarding workplace are optional. Supervisorial District of Workplace - -1234567891011 Neighborhood of Workplace Work Address Work Address: City Work Address: State Work Address: Zip Code Work Phone Number Work Email Address Statement of qualifications: Statement of objectives if appointed: Please select all categories of affiliation or interest that apply to you: Business Disabled Environment Labor Neighborhood Public policy Senior citizen Can you commit to attending regular meetings (about once a month)? * Yes No Not sure Privacy Request (optional) Keep home address confidential Keep home phone confidential Keep home email confidential Please note that the information you provide in this application will be made available to the public. However, if you do not want your home address, home phone number and/or email disclosed, check the appropriate privacy request boxes to have that information redacted from the publicly available copies. Where residence is relevant, a portion of the address (such as street name) may be disclosed. Electronic Signature * Date * Month MonthNov Day Day19 Year Year2018 Applications are considered to be active for two years from submit date. Click submit to complete your application.
