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

oneone youyou selectedselected above?above? YESYES NONO OtherOther Board(Board( s)s) inin whichwhich youyou wouldwould bebe interestedinterested /- /- ff iCAVRIiCAVRI 77 ft0yi.(ft0yi.( TyFTyFyy AoARDAoARD I amam aa residentresident ofof thethe City:City: YESYES NONO * * I HAVEHAVE BEENBEEN aa residentresident forfor yearsyears I ownown propertyproperty inin thethe CRACRA District:District: YESYES NONO *" *" 11 workwork inin thethe CRACRA District:District: YESYES NONO I amam aa registeredregistered voter.voter. YESYES 0--'0--' NONO SIGNATURE SIGNATURE '/— '/— DATEDATE 3a3a 4&/ 4&/ GG NOTE:NOTE: Application Application effectiveeffective forfor ONEONE YEARYEAR fromfrom datedate ofof submission.submission. 833833 - - 99259925 IfIf youyou havehave anyany questionsquestions onon thethe above,above, pleaseplease callcall thethe CityCity Clerk,Clerk, HelenHelen Spencer,Spencer, atat 833833 - - 95099509 oror thethe CityCity HallHall TDDTDD # # INFORMATION INFORMATION BELOWBELOW FORFOR USEUSE ONLYONLY BYBY THETHE CITYCITY AppointedAppointed to:to: DateDate ofof originaloriginal appointment:appointment: LengthLength ofof Term:Term:  SEAPRAY CONDOMINIUMS PAGE 02 008 18: 11 8502441109 CiTY OF FORT WAL'TON BEACH APPLICATION TO SERVE es Boards, On Refe ene I' CCodi Codified oordiniart o Fort Walton BeaohS Section 2- 0) dame: - tk) ca . f{ ome address: " - - lw ail: I tr)me phone: Business phone: _ , n — Ay -/ Occupation: _ aA 0 Z4 Brief Resume of Education and txpenence r> What options would you initiate if appointed !. f I-iow you would address issues if appointed _ fee other side of spOication for CHECK ANY oNqOF THE FOLLt IWING POLICE OFFICERS' BEAUTIMCATION COMM1171 TEE FIRE FIGHTERS' RE REMENT RETIREMENT FUND FUND must be a resident) _ MUNICIPAL PLANNING BOARD BOARD OF ADJUSTMENT FWB HOUSING AUTHORITY must be a resident) must be a resident for 2 yrs and a registered voter) VISION PLAN STEWARDSHIP GOLF CLUB ADVISORY CODE ENFORCEMENT BOARD COMMITTEE COMMITTEE must be a resident) ifi7_An- at -iarae must be a resdden HISTORIG ADVISORY FORT WALON 131EAIiCH COMMUNITY REDEVELQPMENT AGENCY SBQARD WATERFRONT must to a City resnivim, .,... • roe or work in the district k-- - No YES 4. Do any circumstances /conditions exist w rich may inhibit your ability to be totally objective? _ It yes, explain: 4. What special t}ualifications do you feel yoi will bring to this Board? if V 6, Until you are selected the Board of yon ir choice, may we submit your application when vacancies occur rather than contacting you? YES _ No, l wish to be cc ntacted first. I YES . _. _— NO Would you consider serving on another I toard other han the one you selected above? Other Board(s) in which you would be IN crested i_ , Years I am a resident of the Cit.,: YES J NO * 1 HAVE BEEN a resident for _ I work in the CRA District: YES NO NQ " I own property in the GRA Distri ;t: YES I am a registered voter. YES „ NO SIGNATURE ^ DATE L4z1a:' YEAR ft -)m date of submission - DOTE: Application effective for ONE Clerk, Helen Spencer, at 833.9509 or the City Hall TDD # 833 -9925 ii you have any questions on the above,INFO plea ieRMATION call the City BELOW FOR USE ONLY BY THE CifTY Appointed to: Length of Term; C:AtP of original appointment, re- appointed:  CITY COUNCIL MEETING February 12, 2008 Regular Agenda Mayor /Council Comments Council Action 1st 2nd Vote: Agenda Item Number: 18  CITY COUNCIL MEETING February 12, 2008 Regular Agenda City Manager Comments Council Action 1st 2nd Vote: Agenda Item Number: 19