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

Mldontfot' ~' rt ny i1'\the eM CI8tridt YES -=:: I own p,. b.- NO -, worlc In tn. CRA Dlttrld:YES ~ NO_ 1".~.:'" NO_ 1'fYBS~ 1'lIftE. SIGlU. C'~~' i k C\- _ 0 )::\~ ~ OATE /;;.., - I ~...{) ~ NOTE: ,,~ pllcatlon effoctIve fer pNE YEAR from dme of subml. sh~n. If yau haV9 any que&tiOftl on the etl<< C\III' Helen Ne, plene call the City k, tit ~ Spnc;<<, or th8 City Ha,' TOD fF 8~ S92S INFOftMATlON 8ELOW FOR USE OWL'Y' B\'THE COY rnteClto: ate of t) O)__:_ origil'l8\ appointment: ... Length of T6TT11: I 2. 3. How you would address issues if appointed wi U-r<.. c.. ons.; d~ 4{~ 4--~~ q\- o fLU IV ->- ~~"- CHECK ANY ONE OF THE FOLLOWING clease 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- Iarge must be a resident) COMMUNITY REDEVELOPMENT HISTORIC SITES & ADVISORY AGENCY BOARD must be a City resident, own property or work in the district) 4. Do any circumstances/ conditions eXist which may Inhibit your ability to be totally obJective. _ NO _ YES If yes, explain: e.. 3. What special qualifications do you feel you will bring to this Board? S-- e..... onaJ< r 6. 7. Would you consider serving on another Board other than the one you selected above? _ YES _ NO Other Board( s) in which you would be interested __- I am a resident of the City: YES ~ O_* I HAVE BEEN a resident for 1trr~ eJr~ I own property in the CRA District: YES _ NO ~ work in the CRA District: YES ~ am a registered voter: YES _ NO _ SIGNA DATE 8-/ 1/ a~ NOTE: Application effective for ONE YEA 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:  CITY OF FORT WALTON BEACH APPLICATION TO SERVE On City Agencies, Authorities, Boards, Commissions or Committees Reference: Codified Ordinances of Fort Walton Beach - Section 2-60) Name: Home address: TIe phone: upation: 1. Brief Resume of Education and Experience ft.Ue"--<- - t 2. What options would you initiate if appointed? 3. How you would address issues if appointed 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- Iarge must be a resident) II * COMMUNITY REDEVELOPMENT HISTORIC SITES & ADVISORY X AGENCY BOARD must be a City resident, own property or work in the district) 4. Do any drcumstanceslconditions exist which may inhibit your ability to be totally objective? ~ NO YES If yes. explain: . 3. 6. Un~ u are selected for the Board of your choice, may we submit your application when vacancies occur rather than contacting you? YES NO, ( wish to be contacted first. \/ 7. Would you consider serving on another Board other than the one you selected above? YES - Other Board( s) in which you would be interested 4NO I am a resident of the City: YES ~ O_* I HAVE BEEN a resident for / 0 vears RA District: YES ~ O- I work in the CRA District: ~ ES ~ O r~ gist~ red voter: YE; ~ O_ 26/' SIGNATURE DATE 11,-/ eI., OTE: Application effective for ONE YEAR fr date of submission. you have any questions on the above, pie e call the City Clerk, Helen Spencer, at 833- 9509 or the City Hall TDO # 833-9925 IN RMATION BELOW FOR USE ONLY BY THE CITY Appointed to: Date of original appointment: Length of Term: Date( s) re-appointed:  CITY OF FORT WALTON BEACH APPLICATION TO SERVE On City Agencies, Authorities, Boards, Commissions or Committees Ref; rence: Codified Ordinances of Fort Walton Beach - Section 2- 60) Name: Iome address: me phone: cupation: 1. Brief Resume of Education a d Experience m CHECK ANY 0 NE o F THE FOLL o WING please see other side of application for a brief description of duties BEAUTIFICATION COMMITTEE · FIRE FIGHTERS: RETIREMENT . POLICE OFFICERS' FUND RETIREMENT FUND must