Fort Walton Beach Council agenda — 01-23-2007 regular agenda — reading text

lorf- I;" Jh (u/I\d e r smhcl y ! f {t;tck cA. 3. How you would address issues if appointed h/': a 1.-' DI.. ff 1((- VI c.,(~ l cd" ~ Vc:; r:... J CHECK ANY ONE OF THE FOLLOWING please see other side of application for a brief description of duties BEAUTIFICATION COMMITTEE . FIRE FIGHTERS' RETIREMENT . POLICE OFFICERS' FUND RETIREMENT FUND must be a resident) ( must be a resident) BOARD OF ADJUSTMENT * FWB HOUSING AUTHORITY . MUNICIPAL PLANNING BOARD must be a resident) ** ( must be a resident for 2 yrs and a registered voter) CODE ENFORCEMENT BOARD GOLF CLUB ADVISORY . VISION PLAN STEWARDSHIP must be a resident) COMMITTEE COMMITTEE citizen- at- Iarqe must be a resident) COMMUNITY REDEVELOPMENT HISTORIC SITES & ADVISORY AGENCY BOARD V must be a City resident, own Drooertv or work in the district) 4. Do any circumstances/ conditions exist which may inhibit your ability to be totally objective? VNO _ YES If yes, explain: 3. 5 I f\ 6. . Until ~ u are selected for theBoard of your choice, may we submit your application when vacancies occur rather than contacting you? YES _ NO, I wish to be contacted first. 7. Would you consider seNing on another Board other than the one you selected above? VYES _ NO OtherBoard( s) inwhichyouwouldbeinterested Co~. e. E~ forceCM4t1+ fSoqrd I am a resident of the City: YES ~ NO _ * I HAVE BEEN a resident for ! 6 years lawn property in the CRA District: YES _ NO t/ I work - in the CRA District: YES NO v am a registered voter: YES V NO_ SIGNA TUR _ ~ DATE <?'-.) 12- D/' t2. NOTE: Application effective for ONE YEAR from date of submission. If you have any questions on the above, please call the City Clerk, Helen Spencer, at 833- 9509 or the City Hall TOO # 833- 9925 INFORMATION BELOW FOR USE ONLY BY THE CITY Appointed to: Date of original appointment: Length of Term:  12/ 13/ 2005 12: 49 850- 244- 2978 COOLING AND HEATING PAGE 01/ 01 833 9840 CITY OF FORT WALTON 8CH 1<< 1001/ 001 12/' 3/ 2008 ' 0: 22 FAX 850 J,; A"""\"'\" 0. \ ~,\ j C. L~-~ /,= cny OF FORT WALToN lEACH APPLIGATlON" O SERVe On City AgencieS. Authorities, BoardS, Commi881Ol1l or CDmmittees Reforenl:ll: CocIItIec:I Ordm.nC811 of Fott W. ftQn aellCh ~ ~ 2-<< 1) Name; Hornlt addl'884l: Horne phone; Occ;u~: 1. ariefReswne orEdl,atlon and ~ 2. Whm optIona vaould you InItIste If sppolnted'? S, How you would sddl"M'isaues ir~ 1 I\.::)'~ ~ f. i~/~)~ , . CHECK ANY ONE OF T'HE FQLLOWING ........ other. ide of. iPllon for. bIW dual'l on of dutl.. BEAUTIFICATrON COMMITT'EE BOARD OF AOJUS'TM5NT FWe HOUSING AUTHORITY MUNICIPAL PLANNING BOARD must be a retkIent) must be. reaktent for 2.fa )' and II reglsterGd vacer) ootaaIFORCEMGNT-SOARO GQLF CL,UB AOVlSORV must be a resident) COMIIIItmE COMMUNITY REOIiVELO~ M5NT HtSTORIC $ liES a ADVISOR'( AGENCY BOARD mu.t be .. idem. own City.. or wen in the d . 4. Irnatancl:tslcondltians Do any Qfc&. le$,explain: If) IIy objective? ::: e1Ci!It Whleh !My inf'ibIt yeur abiJity to be ~ t& f--: NO _ YES doyOu~ yOu"'~~~~~~. f~~~~~~ a. _-- q~ tf; 2' 6. ~.... ..- Iorthe s.... 01"",,_, ...,.....-.,. or..., n_...... -......... -- - gyou! YES _ NO. I wisn to be contected f' irst. . the one yW seklcted above? ~ C1her"" YES NO 7. Wouki you iclllr COI'I& seMng an another Board Olhlf BotnJ(8) In which you would PIt Interested ~ ~." €" Jf" R ,," TrI-cc "'- ~J . ~ S; ~ ~ am a .. ident ofth. C1ty: yeS ~ NO _ -. HAve BEEN a