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2. Title II Compliance
   In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.
4. First Name*
5. Last Name*
7. Familiar Name, if different than above
8. Email Address*
10. Legal Address*
12. City*
13. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
14. Zip Code*
16. Home Phone Number*
17. Work Phone Number*
18. Cell Phone Number *
20. Employer*
21. Job Title*
23. Employer Address*
25. Employer Primary Contact Name*
26. Employer Contact Phone Number*
28. Have you ever been convicted, plead guilty or plead no contest to a crime?*

    1. Yes
    2. No
29. If yes, please explain*
31. Are you now, or have you been employed by or been an elected official of the City of Modesto or the Modesto Convention and Visitors Bureau?*

    1. Yes
    2. No
32. Do you have relatives or a member of your household who are employed by or are an elected official of the City of Modesto or the Modesto Convention and Visitors Bureau?*

    1. Yes
    2. No
34. Please list your past and present memberships on boards, committees and organizations: (business, civic, commumity, fraternal, political, professional, recreational, religious, and social)*
    Include: Organization, Role/Title and Dates of Service.
36. Please list notable achievements in your service to the organizations you listed above. *
38. Please describe any other volunteer experience:*
40. Please list your fundraising experience:*
42. Please list any relevant employment, training, certificates, licenses or professional registrations:*
44. What makes being a Board Member of the Modesto CVB meaningful to you?*
46. What are some of your prior board or committee leadership experiences?*
48. What skills, connections, resources, and expertise do you have to offer and are willing to use on behalf of the organization?*
50. Do you have any worries or concerns about joining the Board?*

    1. Yes
    2. No
51. If yes, please explain:*
53. Do you have personal aspirations that could be enhanced by Board service?*

    1. Yes
    2. No
54. If yes, please explain:*
56. What motivates you?*
58. What were your expectations from the management of the nonprofits where you've served as a board member?*
60. How important is socially interacting with other board members?*
62. In your own words, define tourism:*
64. In your own words, define hospitality:*
66. How do you believe tourism benefits our community?*
68. What business segment(s) should be the beneficiary of a Convention and Visitors Bureau?*
70. How many times per year do you travel overnight? Business? Leisure? *
72. How many nights did you stay in a hotel outside of Stanislaus County in the last year?*
74. What was your best experience visiting a destination recently?*
76. What was your worst experience visiting a destination recently?*
78. Have you attended a convention or trade show over the last 24 months?*

    1. Yes
    2. No
79. If so, where and what event?*
81. Have you traveled on business or service organization business to destinations outside of the Central Valley in the last 24 months?*

    1. Yes
    2. No
82. If so, where and for what purpose?*
84. In your perspective, what is the role of a Convention and Visitors Bureau?*
86. What interaction should the Convention and Visitors Bureau have with: City Council, City Manager, or other organizations? *
    Please list and make a note for each.
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88. 1. Receive an email copy of this form.
89. Email address

    This field is not part of the form submission.

90. Submit

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