15 Appointment to Boards, Commissions, and Committees

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Received BOARD/COMMISSIONICOMMiTTEE APP~iCATION :, '~ :~ ~ ~'~ The Paris City Council is seeking committed individuals who are dedicated to the well-being f the Paris conununity to serve on its standing boards, commissions, and committees. Un general, it ' f ~S Council's policy to appoint persons to a maximum of two consecutive full three-year terms ~l body. In addition to thg,general qualifications listed in the certification below, other qualifications may be mandated by statute, City Charter, ordinance, or resolution. Please complete the information requested below and return to: City Cleric, 150 SE First StreetlP.O. Box 9037, Paris, Texas 75461. Board/Commission/Committee a~' Interest ^ Airport Advisory Boazd ^ Building & Standards Commission ^ Civil Service Commission ^ Economic Development Corporation ^ Historic Preservation Commission ^ Housing Authority Board of Commissioners ^ Main Street Advisory Board Candidate Information ^ Municipal Band Commission ^ Paris/Lan~ar County Board of Health ^ Planning & Zoning Commission [Public Library Advisory Board ^ Traffic Commission ^ Zoning Board of Adjustment Name: ~ b o r~ ti N a+ d e w Address: t{ 1 L~ O l e~ n~ e r~ r. Work Phone: Home Phone: C( 03 ~ 85 " S(o~ 3 Fax: q p 3 rl $ 5 - 5(P 2 `~ E-mail Address: na .s~ o c- an Sv ~d e ~ I ~ n k . n e.-1- Please note any special knowledge, education, or experience you have that is applicable to the function of the board, commission, or committee of interest {attach additional pages if necessary). If applicable, list dates of service on any City boazds, commissions, or committees. ^ Certification and Authorization 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 State' of Texas regarding nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also certify that if appointed I will attend at least 75 percent of all regular meetings and shall not have any delinquent indebtedness to the City during my term. I understand that the number of posiiions on a given board, commission, or committee is limited and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible futnre notification of topics of interest. I certify that the information given by me in this application is true and correct and any false information or misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify all information provided in this application. in accordance with Section 552 of the Local Government Code, I understand that information provided in this application may be available to the public upon request. Signature of Candidate~~~/d~-~ Date: `f - ~S- ~ ~ -For City Clerk's Use buly ' Conflict of Interest: Y ; N Indebtedness: Y ! N Nepotism: Y / N Dist:: '1 2 3 4 5 6~revious Service: 0 102'.3 4.5 6; City of Paris Revised 02/19108 U ~. ~ L ~aI1cH p~eyoi~ nEZ~ L L 80 9 L ady 6 ~ d tiZ9998LE06