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May 07 08 01:23p Rndy Fasken 903-785-3600 p.l <br />05/97/2008 12:14 9037841799 CI7Y pF PARIS PAGE 01/01 <br />BOARD/CO1'WVI.ISSIQNICONIIVIITTEE APPLICATION <br />The Paris City Council is sceking conunitted individuals who are dedicated to the we,i,l-being of tiae Paris <br />c.ommunity to serve on its •seandyng boards, cc,mnnissions, and comruitters. Iu genjcral, it is Che Ciry <br />Cauncil's policy to appomt persons to a maximum of twa eonsecutive fuil three-year teims on a given <br />body. l.o addition tv the gcncral qu2lificati,c►ns listed iri the ceRiftcaiinn heipw, r~ther quaIifcations may be <br />m. aiaalated Uy stahate, Cily Cl~arter, ordinance, or resolution. PIease cc+mplete ihe in.fozmation requested <br />below Tnd return to: City Clcrls, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. Bo CoAaAnissiodCommittee of Intecest <br />• Ai, purl Advisory Boatd ❑ Municipal Band Commission <br />❑ Building & Staadards Conamission ' <br />❑ Civi] Setvice Commissxon <br />❑ Fc.nnomic Llevetapmcat Corpora.tioa <br />❑ Historic Presezvation Com,naission <br />Hovsm.g Auihor'sty Board of Co.minissioners <br />❑ Mai», Street Advzsory Board <br />Candidate Infmmatiou <br />Work PJione: 5Wrs:JY .3v? ls <br />Fax: E.mail <br />❑ PFUis2mar County Board of Health <br />❑ PIanning & ,Zoning Comm.ission <br />❑ Public Library Advisory Buai•cl <br />❑ Treffic Commission <br />❑ Zonin.g Board of Adjustment <br />~ <br />Home PhonE:__/'~4 <br />Please note aay specxsl knowtedge, cducation, or experience you have that is apAcable to the fwiction of <br />tlie bnArd, eommission, or eommittee of interest (Attach additionai pagcs if (lexxtiaary). Tf applieab.te, list <br />dates af service on any City boards, commissions, oz comrnittees. <br />Ccrtifcation and Aulburimtion • <br />13y sigr►ing bdow, I aclcnowledge tbat i am awere and agrec to the prolubition,c of the City of Paris Charter an.d the laws of thc <br />Stntc of Tcaa.i rcgarding ,iLF,vtiam eiad con111cts of intereSt o1 appotntwS t0 City boands, commissioae, qnd coynaLittoes. I also <br />eertify that if appointed I witl attend at least 75 percent of all negular mcetoogs aad shali not have any delinquent indebtedness <br />to the City during atq tcm,. T understand tJzat th.e numbcr of positiont oja a given bnard, r.c+ramissioa), or committee i- iimirnA <br />an0 that I snay aot be qpointed; howtvcr, if .1 am aol appo.tpted, I agrcc tv be plecxd in a database for passible future <br />notification of topzcs of mterest. I eertify that the information given by ma in t6is apptication is truc an,d correct and aay fnlse <br />int'ormation w- mi9tCpre,cen22ti0e ic SUfflpent grou.nds for disqualificatinn T smtborize che Ci.ry of Paric to vcr;fy ai] <br />infonnation provided in this applicetion, accordance with Section 552 of ihe Iacal Govemment Code, I understanQ that <br />infotmation provided in tltis apVoi9tia ejvailable to the public upon requcst. <br />Siguature otC:andidace: ~P✓',~ Date: <br />Ghy ot PariB ReAsed 08/I9108 <br />* DoIJ2UJ <br />