Committee Application

Personal Information

Tract Number (5 digits, if yours is 4 digits add 0 in front): *

Lot Number (3 digits): *

First Name *

Last Name *

Address *

City *

State: *

Zip *

Email Address *

Phone *

Canyon Lake POA Member Since (Year): *

Qualifications

What is your education? *

What is your current occupation? *

What specific expertise would you bring to the committee in which you are applying for? *

Have you ever served on a Canyon Lake POA committee? *

Yes

If yes, please list committee(s) and date(s) served:

How do you feel you contributed to the above committee(s)?

Committee Member Agreement

I hereby agree, as a condition to my appointment and/or continued service upon a Canyon Lake Property Owners Association Committee to support and uphold the policies of the Canyon Lake Property Owners Association and to be bound by the following provisions: • That I will fully disclose any actual or potential Conflict of Interest, which may affect my service on a Canyon Lake Property Owners Association Committee; • That I will refrain from any participation in a transaction, decision or other matter at issue before the Committee upon which I service, including, but not limited to, refraining from any activity that may lobby or influence the Canyon Lake Property Owners Association staff or my fellow Committee Members as to which I face an actual potential Conflict of Interest; • That I will maintain the confidentiality of any information I receive or become aware of as a result of my services as a Committee Member, and that I will used such information for Canyon Lake Property Owners As

By typing your name in the box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) you are providing is accurate and that you agree to provide this information to the Canyon Lake Property Owners Association in compliance with Civil Code Section 4041, 3) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 4) you may still be required to provide a traditional signature at a later date.

Electronic Signature

	Appeals Commitee
	Architectural Control Committee
	Estates Committee
	Facilities Planning Committee
	Finance Committee
	Green Committee
	Recreation Committee
	Rules & Regulations Committee
	Security Advisory Committee

	Senior Work Group
	Tuesday Work Group

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