Fort Walton Beach Council agenda — 10-09-2007 regular agenda — reading text

COMMUNITY REDEVELOPMENT HISTORIC SITES & ADVISORY FORT WALTON BEACH AGENCY must be a City resident, own BOARD X WATERFRONT COMMITTEE property or work in the district) 4. Do any circumstances/ conditions exist which may inhibit your ability to be totally Objectiv~? ~ NO YES If yes, explain: 3. 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 ~ NO _ * I HAVE BEEN a resident for ~ ears I own property in the CRA District: YES ~ NO I work in the CRA District: YES X NO I am a registered voter: YES ~ NO SIGNATURe-K',,- ~~ DATE 0 ~ ~ 7 t::> 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 8:33- 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: Date( s) re- appointed:  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) I I.. " " i v'-.---"'- v f. ",'~ i .. L c:::::~? fiL -- f~ e -. lA~)i~ V..... (. C (') Name: r \~, ~.-<:. Home address: 7 U"p( 0/ ?(. L>~~ - ( I Home phone: f \.{-U ',,>--- ':~, .::;.::- E- mail: C);>6',,""'" c.e.- &~ c,~ l c..-f t.~'1.:)/~~~ f~.--{!. Occupation: i0 I .0/ J" BUBIhe' ss phone: j ._ 1. Brief Resume of Education and Experience 0 Z,-! d- '-,,:> I ,. e ( f-'-C;\ _ it- ""~,. r l.. LA, LcrL., t? J {- 7t 'c_ A A.J c'"... J Ie.. -- h. " t::..... r f ._~_- '-- k.".' j:>-- ',..... C:-.--< i.~ J ':'./ :.... 2. What options would you initiate if ~PPointed? V'l....() J y... 3. How you would address issues ifappoi ted w~4~ i--- e,.- ,. z;.",.. c Io-- c-L,' V./ ( l- t.e. 9V'() b.- Jt~--._",~" d--- J I J /,....-' . id "r-: - 4.--. l_fY"{ Y(\e../ - YY"'> tJ{2.f" C)~:>!y, 1<1'\ 9-- s::: CHECK ANY ONE OF THE FOllOWING please see othe~ S\ de 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- aHarge must be a resident) COMMUNITY REDEVELOPMENT HISTORIC SITES & ADVISORY ,/ ~ ORT WALTON BEACH. AGENCY BOARD WATERFRONT COMMITTEE must be a City resident, own propertv or work in the district) 4. Do any circumstances/ conditions exist which may inhibit your ability to be totally objective? YES If yes, explain: f (~'\ 3. y~ j" f!\----' jt" t U,,,.." _(,.) _- f . A r-_ TlJ .k- I" t9-- h... ltt+- r krd( r[\ c/!