Name: Required Ethnicity (optional)*: *Individuals of diverse ethnic backgrounds are encouraged to apply. Home County: Required San Francisco County San Mateo County Santa Clara County *Other county (specify below) *Home County (if "other"): Work County: Required San Francisco County San Mateo County Santa Clara County *Other county (specify below) *Work County (if "other"): You may apply for more than one position if you qualify based on this description. To qualify for the public agency representative position, you must be a public agency staff member responsible for bike planning and/or policy development. To qualify for the bicycle advocacy organization representative, you must be a current member of a bicycle advocacy organization. To qualify for the general public representative, you must ride Caltrain and board and/or alight Caltrain in the county that you are applying to represent. * Please specify which public agency or bike advocacy organization you represent (general public applicants need not respond) If you would like to apply to more than one position, indicate the order of preference you would like to be considered for each position by labeling them with a 1, 2, 3, etc. If you are applying to represent only one position, indicate it with a 1. Committee position you are applying for: Santa Clara County General Public Representative Enter a valid ranking. Example: 1, 2 or 3 Santa Clara County Bike Organization Representative Enter a valid ranking. Example: 1, 2 or 3 San Mateo County General Public Representative Enter a valid ranking. Example: 1, 2 or 3 San Mateo County Bike Organization Representative Enter a valid ranking. Example: 1, 2 or 3 San Francisco General Public Representative Enter a valid ranking. Example: 1, 2 or 3 San Francisco Bike Organization Representative Enter a valid ranking. Example: 1, 2 or 3 How often do you ride Caltrain? Seldom/never Occasionally/weekends 1 - 3 times/week 4 - 5 times/week What other modes of transportation do you regularly use? (To select more than one, hold down your Ctrl button while clicking your selection.) BART SamTrans SF Muni VTA Zip Car Bicycle Bike Share Shuttles Other* *If you checked "other" above, please specify which here: Applicant's qualifications for membership: Applicant's objectives if accepted for membership: How did you learn about this opportunity? Required Caltrain website Online search Word of mouth BAC member Brochure on train Brochure at San Mateo County Transit District Caltrain Board meeting BAC meeting Twitter Facebook *City webpage (please state which city below) *Newspaper (please state which newspaper below) *Other (please state how below) *If you checked "city website," "newspaper," or "other" above, please specify here: Optional: Please note that the information you provided on this application will be made available to the public. If you do not want the personal information on the next section disclosed, check the privacy request box. The information will be redacted from the publicly available copies. Where residence is relevant, a portion of the address (such as city and zip code) may be disclosed. Optional Privacy Request Check Box: Privacy request Home Street Address: Required Home City: Required Home Zip Code: Required Phone: Required Enter a valid phone number. Example: 123-456-7890 E-mail Address (a copy of this application will be sent to this address): Required Enter a valid email address. Example: name@company.com Occupation: Optional: You may attach your resume if you wish (limit 2 pages). Only these file types will be accepted: .doc, .docx, .pdf. Resumes provided in connection with your application will be made public. If there is information you do not wish to be made public, please do not include it in your document.