California Latino Legislative Caucus Contact Information Form

Home , Freddie Rodriguez, Jose Medina, Miguel Santiago, Rudy Salas

The mission of the Caucus Committee on Appointments is to recruit, encourage and empower Latinos and Latinas to apply and be appointed to key positions in our state government, including our judicial branch.

Please fill out the contact information below and submit a copy of the requested information for the Caucus to consider submitting a letter on your behalf to the Governor requesting your appointment to state boards and commissions.

Name: ______First Middle Last

Address: ______Home Address City State Zip

Email Address:______Personal email

Employer: ______Title: ______

Work Address: ______Address City State Zip

Work Phone:______Cell Phone: ______

Appointment Applying for: ______

Has a Latino been previously appointed to this post: ______

Authorization: I authorize staff for the California Latino Legislative Caucus to investigate my background and review all of my submitted materials in connection with my request for a letter of support.

Signature: ______

Packet must include:  Contact Information Form  Copy of Your On Line Application for Appointment  Copy of Your Resume  Personal Statement Detailing Your Interest in a Political Appointment  Any Letters of Support

Please Send Completed Packets To: Cesar Anda CA Latino Legislative Caucus CA State Capitol, Room 2117 Sacramento, CA 95814 [email protected] (916) 319-2030

Chair: Asm. Luis Alejo Vice Chair: Sen. Ben Hueso

Senators: Senate President pro Tempore Kevin De León, Ed Hernández, Ricardo Lara, Tony Mendoza Assembly Members: Ian Calderon, Nora Campos, Cristina Garcia, Eduardo Garcia, Jimmy Gomez,

Lorena Gonzalez, Roger Hernández, Patty Lopez, Jose Medina, Henry T. Perea, Anthony Rendon, Freddie Rodriguez, Rudy Salas, Miguel Santiago, Susan Talamantes Eggman, Tony Thurmond

P.O. Box 942849 ♦ State Capitol, Room 2117 ♦ Sacramento, CA 94249-0030 ♦ Phone (916) 319-2030 ♦ Fax (916) 319-2130