CITY COUNCIL VACANCY the City of Fullerton Currently Has a Vacancy on the City Council for an Unexpired Term Ending December 2020

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O FUf; o APPLICATION FOR APPOINTMENT 2 TC4UFOa\ P CITY COUNCIL VACANCY The City of Fullerton currently has a vacancy on the City Council for an unexpired term ending December 2020. The vacant seat is an at -large position. Applicants must be registered

Fullerton voters at the time of application.

Applicants must complete all sections of this form. Applicants must include a 400 -word essay describing why the applicant is the best candidate for appointment and a Fair Political Practices Commission Statement of Economic Interests ( Form 700) with their application.

APPLICANT CONTACT INFORMATION

Address:

City: Fullerton State: CA Zip:

Phone ( H): Phone ( C)

Email:

Which City Council District do you reside in?: District Two

BACKGROUND AND QUALIFICATIONS

Please describe your education and employment background ( attach resume if desired):

Please see attached resume for complete education and employment history.

COMMUNITY INVOLVEMENT

How long have you lived in Fullerton?: 16 Years

Title / Years of any current or previous elected offices held: No current or previous elected offices or position.

Name / Years of any City boards, committees, commissions on which you have served:

State Commissioner California Citizens Redistricting Commission ( 2010 - Present)

Description of other community participation & service: Co -Founding Board member of " Miles for Melanoma 5K," which grew

to be a beloved annual event in Fullerton and is to date the longest running melanoma fundraising nonprofit group in the United States.

Volunteer Medical service provider at county shelters and international medical relief missions for over a decade. ivil, Fraternal or Professional Memberships: Please see attached resume for complete education and employment history.

APPLICANT INFORMATION

What important skills and qualification would you offer as a member of the City Council?: My biggest gualmcations are that I have lived and ran a small business in Fullerton for over a decade. I have served the people of Fullerton as a healthcare provider and have been

honored to represent Oran a County in Sacramento defending it against redisuictim. I love the culture of Fullerton and am excited about its future

What are the most important issues facing the City today?: Fullerton is a great city where people want to live.

This good reputation has brought the challenges of affordable housing parking impaction street and infrastructure

degradation Public safety issues and homelessness With good solutions, the future is very briaht.

Do you have any current obligations or responsibilities that could be construed as a conflict of interest? If so,

please describe: I have no conflicts of Interest My current appointment with the state does not prevent me from serving

REFERENCES

Please provide the names and contact information of five references

1. Dr. William Baugh

Name Address Phone Email

ESSAY

Please attach an essay of no more than 400 words stating why you are the best person to appoint to the Fullerton City Council and submit an electronic copy of the essay to the City Clerk' s Office no later than at the time of application filing. CONFLICT OF INTEREST FORM ( FORM 7001

Please complete and attach a Fair Political Practices Commission Statement of Economic Interests ( Form 700). You can find the form online at http:// www. fppc. ca. gov/ Form700. html or request a copy from the City Clerk' s Office.

I attest to the following:

1. 1 am a registered City of Fullerton voter.

2. 1 have attached an essay of no more than 400 words stating why I am the best person to appoint to the Fullerton City Council.

3. 1 have submitted a Statement of Economic of Interest — Form 700.

4. 1 am able to attend City Council meetings regularly scheduled for 5: 00 p. m. on the 1st and 31d Tuesdays of each month.

S. I understand this application and attachments are public records and may be made available to members of the public upon request, with personal contact information

redacted.

6. The information provided in this application is true and accurate.

January 23, 2019

Submit your completed application, essay and Form 700 in person to the City Clerk' s Office.

City of Fullerton — City Clerk' s Office 303 West Commonwealth Avenue Fullerton, CA 92832 citvclerksoffice @ cityofful lerton. com 714) 738- 6350

Deadline to file is 5: 00 p. m., Wednesday, January 23, 2019. Late submissions will not be accepted.

OFFICE USE ONLY

oter registration verified Essay word count Z90 Form submitted Assay submitted ( 400 word max) Michael Ward City Council Application Essay

I first fell in love with Fullerton as a Cal State undergrad in 1993 and have been proud to be a participant in it since. As a resident, I have valued richly from the unique and diverse cultures that make Fullerton stand apart. As an avid runner who spends weekends on the trails, I have regularly joined with groups who repair and preserve our trails and recreational grounds. As a practicing Chiropractor in Fullerton for 8 years, I had the pleasure of serving all socioeconomic levels of this city and developing a well rounded understanding of how difficult a hardship something like parking can be depending on where you live. Additionally, the education of learning to operate a small business in a rapidly evolving healthcare climate was equally rewarding. I believe all of these experiences rooted in trusted, local relationships throughout the last twenty years make me an excellent choice to be part of this creative Counsel team.

One of the biggest honors I have had is representing Orange County on the California Citizens Redistricting Commission. Asa Tribal member of the Choctaw Nation, I understood well the history and effect of voter disenfranchisement. Therefore, the opportunity to step up and end gerrymandering was a committed goal. Despite efforts to specifically split Fullerton' s votes amongst four different districts, I was able to form an " Orange County Working Group" and partner coalition which successfully kept Fullerton from being dissected and our votes diluted. This is something I could not have accomplished without the help of citizens getting involved and caring about their city. Other keys to success for me were the ability to quickly comprehend dense data sets, comprehend complex federal and state law, long range planning, work well with opposing views and be willing to understand testimony from the circumstances of the person giving it.

I truly believe that I have a lot to offer the City of Fullerton and the City Counsel itself. As a City Counsil teammate, I want to bring my strong analytical skills, project management experience and optimistic willingness on board. And to the residents of Fullerton, I have been in positions of trust for twenty years with no negative words or scandals. My character has been battle tested and stands intact. Speaking as a resident, that by itself instills the trust and confidence required to truly solve some of the toughest issues facing the city. Dr. Michael W. Ward

EDUCATION: Doctorate of Chiropractic Medicine (D. C.) April 2006 Southern California University of Health Sciences Honors Graduate

Bachelor of Arts ( B. A.) Communications June 1997 California State University Fullerton Honors Graduate

Registered Trigenics Physician of Myoneural Medicine April 2006 Trigenics Institute of Myoneural Medicine Certificate

Marston Polygraph Academy April 2006 Certification of Art and Science of Polygraph APA Certified

Office of Special Investigations, USAF December 1997 Federal Law Enforcement Basic and Advanced Courses Distinguished Graduate

LICENSE: California licensed Doctor of Chiropractic - # DC 30367 ( valid until 4/ 30/ 2019)

PROFESSIONAL EXPERIENCE: California Citizens Redistricting Commission Sacramento, CA Title: Commissioner / Chairperson Dec 2010 —Present Selected to serve California' s ' first-ever' independent Citizens Redistricting Commission ( CCRC) charged with drafting districts for the states 53 US House of Representatives, 80 state Assembly, 40 state Senate seats and 4 Board of Equalization seats. Lead the Public Outreach and Finance/ Administration Subcommittees helping enable the Commission to hold 36 public hearings throughout the state to consider testimony from all of California' s diverse communities. Established the " Orange County Working Group" to combat the priority given to Los Angeles County in the redistricting deliberations leading to three representational districts recovered as a direct result of this effort

Served as an active member of the Legal Affairs Subcommittee.

Ward Chiropractic Fullerton, CA Title: Doctor of Chiropractic and Sports Medicine Jan 2011— 2015 Primary treating Chiropractor specializing in athletic injury rehabilitation and neurologic firing pattern coordination in both professional ( MLB, Olympic Dr. Michael W. Ward Page 2 of 4

Track) and amateur competitive athletes. Lead Chiropractor invited to the 2012- 2013 PAC -12 Decathlon Championships

providing axial, non -axial and physiotherapies. Participate in regular ( 23 to date) multi -discipline medical missions trips to foreign countries to provide healthcare to impoverished communities in Ireland, Costa Rica,

Mexico, Thailand, Zimbabwe and South Africa.

Los Angeles Police Department Los Angeles, CA Title: Supervisory Polygraph Examiner June 2015 - Present Full- time examiner conducting criminal and pre- employment polygraph testing in line with National Center for Credibility Assessment ( NCCA) and Police Law Enforcement Accredidation ( PLEA) standards. Selected as a Quality Control Reviewer tasked with certifying that each exam meets federal standards and practices prior to being finalized. Highly recognized interrogation skills including a decoration for garnering an admission of active foreign service espionage during a pre- employment exam.

Marston Polygraph Academy San Bernardino, CA Title: Lead Instructor March 2010 - Present Lead instructor for 'Anatomy and Physiology', ' Statistics' and ' Scientifically Validated Research Methodologies'. Authored over 75 hours of scientifically validated polygraph curriculum including test data analysis and countermeasure detection.

Office of Special Investigations, USAF Washington D. C. Title: Special Agent / Operations Officer 1997 —2002 Directed all facets of complex criminal, fraud and counterintelligence investigations with specialized training in criminal forensics, electronic media analysis, sex crimes and contracting/ financial fraud. Hand- picked to architect the creation of a 24/ 7 Department of Defense global crisis and threat watch ensuring timely and accurate response to over 144 investigative units and dozens of other federal agencies worldwide. This included the implementation of operating policies, manning studies, technology and database leveraging and communication assuredness. Presentation and negotiation experience at all organizational levels. Participated in the first response effort to 9- 11 Pentagon attack and was a sitting member of the New Mexico Federal Bureau of Investigations threat working group.

Membershlos / Volunteer Work:

Choctaw Nation of Oklahoma — Tribal Member

American Polygraph Association — Full Member California Chiropractic Association — Member

Christian Chiropractic Association — Member Dr. Michael W. Ward Page 3 of 4

Delta Tau Alpha Honors society— Member Delta Sigma Honorary Scholastic Society of the Healing Arts —Member Golden Key National Honors Society — Member

AWARDS/ RECOGNITIONS: Harvard University Ash Center Innovation Award for Public Engagement in Government, 2017 (California Redistricting Commission) California Common Cause " We the People" Award, 2017 San Francisco Chronicle " Californians of the Year" Award, 2011 SCUHS Certificate of Internship for Outstanding Proficiency in Clinical Practice 2011 Delta Tau Alpha Chiropractic Academic Honors Society, Awarded Member, 2006 Delta Sigma Scholastic Excellence Society of the Healing Arts, Awarded Member 2006 Air Force Meritorious Service Commendation, 1999 AFROTC Silver Medal of Valor, 1998 ( sole recipient in a decade) City of Anaheim Mayors' Outstanding Citizen Award, 1997 Distinguished Graduate, Air Force Office of Special Investigations Academy, 1997 Distinguished Graduate Air Force Reserve Officer Training Corps., 1997 National Golden Key Honors Society Academic Excellence Award, 1997 Kappa Tau Alpha Honors Society Academic Excellence Award, 1997

MEDIA/ PRESS INTERVIEWS: Print: The Journal, California Chiropractic Association, Vol. 36 Issue 2, Spring 2011, Pages 26- 27. http:// www. ccajournal. com/ CCA- Spring- Journal- 2011. pdf The Biskinik, April 11, 2011, PAGE 16 http:// s3. amazonaws. com/ choctaw- msldigital/ assets/ 740/ BISKINIK2011 04 original pcif Los Angeles Times, April 20, 2011, " Redistricting and Healthcare", Opinion section, CQ Researcher ( Congressional Quarterly), February 2011, " Redistricting Debates"

Television: Time Warner Cable, " Local Edition", April 25, 2011 http:// www. youtube. com/ watch? v= OieFv3X[ Jws& featu re= related NBC News, " Channel 3 Noon News", Coachella Valley, May 12, 2011 http:// www. youtube. com/ watch? v= mlnoN8QfFAE California State Capitol Press Conference regarding 2012 Redistricting Commission, August 15, 2011 http:// www. youtube. com/ watch? v= w8tLvL-- h- 4 NBC News, " News Conference", August 19, 2011 http:// www. nbclosangeles. com/ on- air/ as- seen- on/ Newsconference_ Ca_ Citizens_ Red istricting_ Commissioner_ Dr_ M ich ael_ War d_ Los_ Angeles- 128112628. html Cable News Network ( CNN), " Gerry -Rigged, why your vote may not count", 15 Oct 2011 http:// www.youtube. com/ watch?v= eelbHPXwDM4 Dr. Michael W. Ward Page 4 of 4

KEYNOTE SPEAKING ENGAGEMENTS: Redistricting and State Commission related: Califonria Common Cause Spotlight on California ( Dec 2017) Azusa Pacific University Political Science/ Redistricting Forum ( Feb 2012) Santa Clarita Lincoln Club ( Oct 28, 2011) Los Angeles California Club ( Oct 6, 2011) Biola University Legislation 406 Class ( Oct 4, 2011) California State University Fullerton and League of Women Voters Redistricting Forum ( Sept 24, 2011) Long Beach Lincoln Club ( Sept 22, 2011) Orange County Lincoln Club ( Sept 13, 2011) California Women' s Leadership Association ( Aug 20, 2011) TATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received OKclal Use Only COVER PAGE

Please type or print in ink. A PUBLIC DOCUMENT

NAME OF FILER ) LAST) ) FIRST) ) MIDDLE)

Ward Michael William

1. Office, Agency, or Court

Agency Name ( Do not use acronyms) Fullerton City Council Division, Board, Department, District, if applicable Your Position

Applicant

If filing for multiple positions, list below or on an attachment. ( Do not use acronyms)

Agency: Position:

2. Jurisdiction of Office ( check at feast one box)

State Judge or Court Commissioner ( Statewide Jurisdiction)

Multi -County County of City of Fullerton Other —

3. Type of Statement ( check at feast one box)

Annual: The period covered is January 1, 2018, through Leaving Office: Date Left --- J---J— J- December 31, 2018. ( Check one circle.)JDecember or- The period covered is J through O The period covered is January 1, 2018, through the date of December 31, 2018. or- leaving office.

Assuming Office: Date assumed O The period covered is — J— I through the date of leaving office. 02/ 2019 Candidate: Date of Election and office sought, If different than Part 1: Council Member

4. Schedule Summary ( must complete) I Total number of pages including this cover page: 4 Schedules attached

x Schedule A- 1 - Investments - schedule attached Schedule C - Income, Loans, & Business Positions - schedule attached

Schedule A-2 - Investments - schedule attached Schedule D - Income - Gifts - schedule attached

Schedule B - Real Property - schedule attached Schedule E - Income - Gifts - Travel Payments - schedule attached

or- None - No reportable interests on any schedule

MAILING ADDRESS STREET CITY STATE ZIP CODE Business or Agency Address Recommended - Pudic Dacumenp

I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the Stale of California that the foregoing is true and correct.

Date Signed 01/ 23/ 19 Signature month, day year)

FPPC Form 700 (2018/ 2019) FPPC Advice Email: advice@fppaa. gov FPPC Toll - Free Helpline: 866/ 275- 3772 fpp ca. gm Page - 5 SCHEDULE A- 1 CALIFORNIA 700 Investments FAIR POLITICAL

Stocks, Bonds, and Other Interests Name Ownership Interest is Less Than 10%) Michael Ward Investments must be itemized. Do not attach brokersoe or financial statements.

Falls Event Center ( Utah) Bottom Up Ventures ( San Diego)

GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS

Event Planning and Hosting Real Estate Refurbishment

FAIR MARKET VALUE FAIR MARKET VALUE

2, 000 - $ 10, 000 $ 10, 001 - $ 100, 000 2, 000 - $ 10, 000 $ 10, 001 - $ 100, 000 X $ 100, 001 - $ 1, 000, 000 Over $ 1, 000, 000 X $ 100,001 - $ 1, 000,000 Over $ 1, 000, 000

NATURE OF INVESTMENT NATURE OF INVESTMENT Convertible note X Stock Other Stock X Other Desaiba) Desaibe) Partnership O Income Received of $ 0 - $ 499 Partnership O Income Received of $ 0 - $ 499 O Income Received of $ 500 or More ( Report on schedule C) O Income Received of $ 500 or More ( Report on Schedule C)

IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED ACQUIRED DISPOSED

NAME OF BUSINESS ENTITY NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE FAIR MARKET VALUE

2, 000 - $ 10, 000 $ 10, 001 - $ 100, 000 2, 000 - $ 10, 000 $ 10, 001 - $ 100, 000 10o, 001 - $ 1, 000, 000 Over $ 1, 000, 000 100, 001 - $ 1, 000, 000 Over $ 1, 000, 000

NATURE OF INVESTMENT NATURE OF INVESTMENT Stock Other Stock Other

Describe) Describe) Partnership O Income Received of $ 0 - $ 499 Partnership O Income Received or $ 0 - $ 499 O Income Received of $ 500 or More ( Report on Schedule Cl O Income Received of $ 500 or More ( Repan on schedule C)

IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE:

JJ1 JJ1 JJ1 JJ1 ACQUIRED DISPOSED ACQUIRED DISPOSED

NAME OF BUSINESS NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE FAIR MARKET VALUE

2,000 - $ 10,000 $ 10, 001 - $ 100, 000 2, 000 - $ 10, 000 $ 10, 001 - $ 100, 000 100, 001 - $ 1, 000, 000 Over $ 1, 000, 000 100, 001 - $ 1, 000, 000 Over $ 1, 000, 000

NATURE OF INVESTMENT NATURE OF INVESTMENT

Stock Other Stock Other Descnbe) Desaibe) Partnership O Income Received of $ 0 - $ 499 Partnership O Income Received of $ 0 - $ 499 O Income Received of $ 500 or More ( Report on Schedule C) O Income Received of $500 or More ( Report on schedule C)

IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE:

JJ1 _/ J1Z ACQUIRED DISPOSED ACQUIRED DISPOSED

Comments:

FPPC Form 700 (2018/ 2019) FPPC Advice Email: adviceMfppc.ca. gm FPPC Toll - Free Helpline: 866/ 215- 3792 . . fppc. ca. gov Page -] SCHEDULE C CALIFORNIA FORM 700 Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION I Positions Name Other than Gifts and Travel Payments) Michael Ward

NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME

Los Angeles Police Department Ward Chiropractic and Sports Medicine

ADDRESS ( Business Address Acceptable) ADDRESS ( Business Address Acceptable) 555 Ramirez St 121 S Royal PI, Anaheim, CA

BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE

Polygraph Examiner If Interrogations Specialist Sports Medicine and Chiropractic Science

YOUR BUSINESS POSITION YOUR BUSINESS POSITION Civilian Employee Owner

GROSS INCOME RECEIVED No Income - Business Position Only GROSS INCOME RECEIVED No Income - Business Position Only

500 - $ 1, 000 $ 1, 001 - $ 10, 000 500 - $ 1, 000 $ 1, 001 - $ 10,000

10, 001 - $ 100, 000 X OVER $ 100, 000 X $ 10, 001 - $ 100, 000 OVER $ 100, 000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED

X Salary Spouse' s or registered domestic partner' s income X Salary Spouse' s or registered domestic partner' s income Far self- employed use Schedule A-2.) For self-employed use Schedule A-2.)

Partnership ( Less than 10% ownership. For 10% or greater use Partnership ( Less than 10% ownership. For 10% or greater use Schedule A-2.) Schedule A-2.)

Sale of Sale of Real Property car, bo f, etc.) Real property, car, boat, etc) Loan repayment Loan repayment

Commission or Rental Income, list each source of $ 10, 000 or more Commission or Rental Income, list each source of $ 10, 000 or more

Other Other Descdbe) ( I I Ossaibe) 2 LOANS RECEIVED OR OUTSTANDINGDURING THE REPORTINGea

You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender' s regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender' s regular course of business must be disclosed as follows:

NAME OF LENDER' INTEREST RATE TERM ( Months) Years)

None ADDRESS ( Business Address Acceptable)

SECURITY FOR LOAN

BUSINESS ACTIVITY, IF ANY, OF LENDER None Personal residence

Real Property

HIGHEST BALANCE DURING REPORTING PERIOD

500 - $ 1, 000

1, 001 - $ 10,000 Guarantor 10, 001 - $ 100,000

OVER $ 100, 000 Other Oescnbe)

Comments:

FPPC Form 700 (2018/ 2019) FPPC Advice Email: advic. @fppc. ca. gov FPPC Toll -Free Helpline: 8661275- 3772 vn wfppc. ca. gov Page - 13 SCHEDULE C Income, Loans, & Business Name Positions Other than Gifts and Travel Payments) Michael Ward

NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME California Citizens Redistricting Commission Advanced Lie Detection

ADDRESS ( Business Address Acceptable) ADDRESS ( Business Address Acceptable) 1017 L Street, Sacramento, CA 121 S Royal PI, Anaheim, CA

BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE State Commissioner Corporate and Government Polygraph Services

YOUR BUSINESS POSITION YOUR BUSINESS POSITION Term ends in 2020 Owner

GROSS INCOME RECEIVED X No Income - Business Position Only GROSS INCOME RECEIVED No Income - Business Position Only

5o0 - $ 1, 000 $ 1, 001 - $ 10, 000 500 - $ 1, 000 X $ 1, 001 - $ 10, 000

10,001 - $ 100, 000 OVER $ 100,000 10, 001 - $ 100, 000 OVER $ 100, 000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED

Salary Spouse' s or registered domestic partner' s income X Salary Spouse' s or registered domestic partner' s income For calf -employed use Schedule A-2.) For self-employed use Schedule A-2.)

Partnership ( Less than 10% ownership. For 10% or greater use Partnership ( Less than 10% ownership. For 10% or greater use Schedule A- 2.) Schedule A-2.)

Sale of Sale o Real Property, oar, boar, etc.) Real Moparl coq boa( etcJ

Loan repayment Loan repayment

Commission or Rental Income, list each source of $10, 000 or more Commission or Rental Income, list each source of $10,000 or more

Describe)

X Other Volunteer position as of 2017 Other Describe) I I ( Describe) LOANSa OR OUTSTANDING DURING THE REPORTINGea

NAME OF LENDER' INTEREST RATE TERM ( Months/ Yeam)

None ADDRESS ( Business Address Acceptable)

SECURITY FOR LOAN

None Personal residence BUSINESS ACTIVITY, IF ANY, OF LENDER

Real Property,

HIGHEST BALANCE DURING REPORTING PERIOD

500 - $ 1, 000

1, 001 - $ 10, 000 Guarantor 10,001 - $ 100,000

OVER $ 100, 000 Other

DescAbe)

Comments:

FPPC Form 700 (2018/ 2019) FPPC Advice Email: adNceiRrppc. o.,im HmC Toll -Free Helpline: 866/ 275-3772 www.fppcAa.Page -gm13