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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 />Received <br />Board/Commission/Committee of Interest <br />^ Airport Advisory Board <br />[I] Building & Standards Commission <br />^ Civil Service Commission <br />^ Economic Development Corporation <br />^ Historic Preservation Commission <br />^ Housing Authority Board of Commissioners <br />^ Main Street Advisory Board <br />^ Municipal Band Commission ~~~' ~ ~ ~~ ~$ <br />^ Paris/Lamar County Board of Health City/ Of Par1S <br />^ Planning & Zoning Commission Ctty CI®Iic <br />^ Public Library Advisory Board <br />^ Traffic Commission <br />[] Zoning Board of Adjustment <br />Candidate <br />Name: <br />Address: -1 t l OAd' Lt~w-O ~~"' <br />Work Phone: ~!?,~ 7~~ ~ `?~ l Home Phone: ~.~~~ ~ ~f7 y <br />Fax: ~d 3 7 g~ ~~a 17~? E-mail Address: /~~ ~~.~,~t ~ t N~~-: (, Gd~tn <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 />of service on any City boards, commissions, or committees. <br />~~`~a,~41d. Ly,.a,~,~u,~rl~-ice ~s~~~ <br /> <br />Certification and Authorization <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 grou for disqualification. I authorize the City of Paris to verify all <br />information provided in this applicatio nZacco d e with Section 552 of the Local Government Code, I understand that <br />information provided in this appli ay a l to the public upon request. <br />Signature of Candidate: ~ Date: ~' ~"~ <br />G <br />Conflict of Interest: Y/ N Indebt Hess: Y/ N ,' a m: Y/ N Dist.: 1 2 3 4 5 E~revious Serv~e~0 12 3 4 5 6 <br />City of Paris Revised 08/19/08 <br />a Uy ~L <br />