Fort Walton Beach Council agenda — 02-12-08 regular agenda — reading text

NONO • • I HAVEHAVE BEENBEEN aa residentresident forfor_ _ yearsyears % % fcfc NONO I workwork InIn thethe CRACRA DistrictDistrict YESYES NONO 1 ownown propertyproperty inin thethe CRACRA District:District: YESYES N01N01 mm aa registered registered voter,voter, YESYES ;, _ ;, _ aa SIGNATURSIGNATUR DATEDATE C'C'. (. ( AA dd , , fromfrom datedate ofof submission,submission, NOTE;NOTE; ApplicationApplication efbeattveefbeattve forfor OldOld YEAYEA 1414 unuunu ll haunhaun AnvAnv eueu " " Nnn®Nnn® anan thethe above,above, bieasebiease callcall thethe CityCity Clark.Clark. HelenHelen Spencer,Spencer, atat 633633 - - 85088508 oror thethe CityCity HallHall TDOTDO 00 653653 - - 99269926 1140RnnATiON 1140RnnATiON BELOWBELOW FORFOR USEUSE ONLYONLY BYBY THETHE CITYCITY AppointedAppointed to:to:. . ww GateGate ofof originaloriginal appointment*appointment* _ _ LengthLength ofof Torm:Torm: ..._ _._..._ _._ Date(Date( s)s) re-re- appointed:appointed: --- -- --- --  CITY OF FONT WALTON BEACH APPLICATION TO SERVE On City Agencies, Authorities, Boards, Commissions or Committees Section 2 -60) Reference: Codified Ordinances of Fort Walton Beach - Name: T! L.LrRA. J /!+ ••. r.. r rne address- = DSts Laz' ne phone: 2 —3 2 6 ccupation: L' ttAA1Z1C12 cif' " AMA 0 10 MS to s7u BA .- JlSic Brief Resulne of Education and Exp rience hU 1 1. 0* AO it G c N l.G 2 L.D,w.cr Vie.& - f1tA 2. What_options would you initiate if appointed? r 3. How you would address issues if apF B G a r, Tf/ Ii C c- WA btiJ7" _ A 9- 2- _. c s...... I%rinf Aftot+rinfinn of thi iPC a.` " ••• • r..___._ -- QHhU1'KANY VIVO. yr r r-rvi.wvvnw N FIRE FIGHTERS' RETIREMENT POLICE OFFICERS' BEAUTIFICATION COMMITTEE FUND RETIREMENT FUND must be a resident) must be a resident FWB HOUSING AUTHORITY MUNICIPAL PLANNING BOARD BOARD OF ADJUSTMENT must be a resident) must be a resident for 2.yrs and a regi r d voter) GOLF CLUB ADVISORY VISION PLAN STEWARDSHIP CODE ENFORCEMENT BOARD COMMITTEE must be a resident) COMMITTEE citizen-at-large must be a resident HISTORIC SITES & ADVISORY FORT.WALTON BEACH COMMUNITY REDEVELOPMENT BOARD WATERFRONT COMMITTEE AGENCY must be a City resident, own property or work in the district 4.4. DoDo anyany circumstancescircumstances / / conditionsconditions existexist whichwhich maymay inhibitinhibit youryour abilityability toto bebe totallytotally objective?objective? _ _ X_X_NONO YESYES IfIf yes,yes, explain:explain: _ _ 3.3. tionstions dodo you II qualifications WhatWhat specialspecial qualifications yy you feelfeel you YY you wilwil bnnbnn toto thisthis Board?Board? (. (. dd P,P,DD VV i/i/ PP i/i/ aDaD LotdLotd 66 aa L17-L17- AO%AO% 47174717Isex,Isex, MM tstatsta AAAA juAeZYjuAeZY li,li, 494K494K ' ' titi 6.6. UnUn ' ' ouou areare selectedselected forfor thethe BoardBoard ofof youryour choice,choice, maymay wewe susu mritmrit youryour appapp nationnation whenwhen vacavaca cici ss occuroccur ratherrather thanthan contacting contacting you?you? YESYES NO,NO, 1 wishwish toto bebe contactedcontacted first.first. 7.7. IdId WouldWould ouou considerconsider servingserving99 onon anotheranother BoardBoard otherother thanthan thethe oneone youyou selectedselected above?above?