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BOARD/COMMISSION/COMMITTEE APPUCATION <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 tRece <br />body. In addition to th general qualifications listed in the certification below, other qualifications may be <br />mandated by statute, ~ity Charter, ordinance, or resolution. Please complete the infornR#nqray~u"~d <br />below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. <br />Ci#y of Paris <br />Board/Commission/Committee of Interest City Clerk <br />❑ Airport Advisory Board <br />❑ Building & Standards Commission <br />❑ Civil Service Commission ' <br />❑ Economic Development Corporation <br />F71 Histor;. Preservation Commissian <br />Iousing Authority Board of Commissioners <br />❑ Main Street Advisory Board <br />Candidate Information <br />❑ Municipal Band Commission <br />❑ Paris/Lamar County Board of Health <br />❑ Planning & Zoning Commission <br />❑ Public Library Advisory Board <br />❑ Traffic Commission <br />❑ Zoning Board of Adjustrnent <br />Name: <br />Work Phone <br />S%i c 151-aA/ <br />Fax: 3 - 2 xt- 5Z 3 - <br />Home Phone:,/:::~3 ' ~ k,3 <br />E-mail Address: e-Ayt 00wu~~ <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 />Z jooq 7-eriq z ✓~s / v~~ <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 grounds for disqualification. I authorize the City of Paris to verify all <br />information provided in this applica 'In accordance wi ection 552 of the Local Government Code, I understand that <br />information provided in this appli ti n may e av i le t e public upon request. <br />Signature of Candidate: Date: g~~ <br />For Citv Cler.k's Use Onlv <br />Conflict of Iaterest: Y/ N Indebtedness: Y/ N Nepotism: Y/ N Dist.: 1-2 3 4 5 6 7 Previous Seivice: 0 12 3 4 5 6 <br />City of Paris , Revised 02/19/08 <br />- 0Q02S f <br />