RESUME
CSEA Board of Trustees Application
Serve your city. Help shape the future of civil service in Cleveland. Complete the application below to be considered for a Trustee position.
Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Email
*
example@example.com
Primary Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Title: Employment (City of Cleveland Employees Only)
Employment History
Department or Division
Title
Date Start
-
Month
-
Day
Year
Date
Date Ended
-
Month
-
Day
Year
Date
Department or Division
Title
Date Start
-
Month
-
Day
Year
Date
Date Ended
-
Month
-
Day
Year
Date
Character References
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation
What skills, experience, or knowledge can you bring to CSEA?
Why do you want to serve as a trustee?
Emergency Contact
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I certify that the information provided is accurate to the best of my knowledge. I understand that as a Trustee of the Civil Service Employees’ Association, I may have access to sensitive financial, legal, and proprietary information and agree to keep it confidential. I acknowledge that violations may result in removal and possible legal action. This agreement remains in effect for five (5) years after my service ends, with attorney-client information remaining confidential indefinitely.
I agree to the Confidentiality Agreement
*
Yes
Signature
SWORN TO BEFORE ME AND SUBCRIBED IN MY PRESENCE THIS DAY
*
Date
-
Month
-
Day
Year
Date
Notary Signature and Stamp
Submit
Should be Empty: