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BOARD/COMMISSION/COMMITTEE APPLICATION <br />The Paris City Council is seeking committed individuals who are dedicated to the well-being of the Paris <br />community to serve on its standing boards, commissions, and committees. In general, it is the City <br />Council's policy to appoint persons to a maximum of two consecutive full three-year terms on a given <br />body. In addition to the general qualifications listed in the certification below, other qualifications may be <br />mandated by statute, City Charter, ordinance, or resolution. Please complete the information requested <br />below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. <br />Board/Commission/Committee of Interest <br />^ Airport Advisory Board <br />^ Building & Standards Commission <br />^ Civil Service Commission <br />^ Economic Development Corporation <br />^ Historic Preservation Commission <br />^ Housing Authority Board of Commissioners <br />^ Municipal Band Commission <br />^ Paris/Lamar County Board of Health <br />^ Planning & Zoning Commission <br />^ Public Library Advisory Board <br />^ Traffic Commission Received <br />[]'L~oning Board of Adjustment ~~R 1 ~- ~~;r,g <br />Work Phone: Q' b3 7 1P~ 3 ~~ Z Home Phone: ~ O.~ 7 ~~ ~ y ~S <br />Fax:~~~ 7 g3 3 ~~S E-mail Address:~~ i' ~ > ~ . ~,. o ~ <br />Please note any special knowledge, education, or experience you have that is applicable to the function of <br />the board, commission, or committee of interest (attach additional pages if necessary). If applicable, list <br />dates of service on any City boards, commissions, or committees. <br />Certification and Authorization <br />%~ a OU~L <br />i.V U /~ ~ <br />c. <br />By signing below, I acknowledge that I am aware and agree to the prohibitions of the City of Paris Charter and the laws of the <br />State of Texas regarding nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also <br />certify that if appointed I will attend at least 75 percent of all regular meetings and shall not have any delinquent indebtedness <br />to the City during my term. I understand that the number of positions on a given board, commission, or committee is limited <br />and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible future <br />notification of topics of interest. I certify that the information given by me in this application is true and correct and any false <br />information or misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify all <br />information provided in this application. In accordance with Section 552 of the Local Government Code, I understand that <br />information provided in this application may be avai ble to he public upon request. <br />Signature of Candidat : Date: ~--~-' ~ <br />For Citv Clerk's Use Only <br />Conflict of Interest: Y/ N Indebtedness: Y/ N Nepotism: Y/ N Dist.: 1 2 3 ®5 6 7 Previous Servicet 0 1 2 3 4 5 6 <br />City of Paris Revised 08/19/08 <br />U 11 ca <br />^ Main Street Advisory Board <br />Candidate Information C~tv Clefk~ <br />