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BOARD/COMMISSION/COMMITTEE APPILICATION <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 th general qualifications listed in the certification below, other qualifications may be <br />mandated by statute, ity Charter, ordinance, or resolution. Please complete the informRsu ` <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 ❑ Economic Development Corporation <br />~ Historic Preservation Cominission <br />❑ Housing Authority Board of Commissioners <br />❑ Main Street Advisory Board <br />A,"R 3 %008 <br />❑ Municipal Band Commission C~y of Paris <br />Clfy Cfw#C <br />❑ Paris/Lamar County Board of Health <br />❑ Planning & Zoning Commission <br />❑ Public Library Advisory Board <br />❑ Traffic Commission <br />❑ Zoning Board of Adjustment <br />Candidate Information <br />Name: 9c= w /A l/Awal~ l4& <br />~ S 7~~f-6 d <br />Address: ~a a~'~ c.~ ~ C~ ~ /D <br />Work Phone: /3 Home Phone: G' 3 7~ 5 3~ 5`7 <br />Fax: fVIA E-mail Address: 1?c_NmV4N <cf•vrv0 L~mC/lv/1 J~<C_v' <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 />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 applicatior~;a In accordance with Section 552 of the Local Government Code, I understand that <br />information provided in this application may be available to the public upon request. <br />Signature of Candidate• o~ ~~Date:t>fi-' -1 S`d <br />For Citv Clerk's Use.Only " <br />ConflicY of Interest: Y/ N InQebtedness: Y/ N Nepotism: Y/ N Dist.: 12 34& 7 Previous 5ervice&2 3 4 5 6 <br />City of Paris <br />Revised 02/19/08 <br />~ <br />000260 <br />