15 Appointment to boards, commissions and committees

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Received BOARD/C4MMISSION/COMMITTEE APPUCATION R 08 The Paris City Council is seeking cammitted individuals who aze dedicated to the well-being f the Paris community to serve on its standing boards, commissions, and committees. In general, it ' f~~S Council's policy to appoint persons to a maatimuan of two consecutive full three-year terms i body. In addition to thg, general qualifications listed in the certification belaw, 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 Stree#/P.O. Box 9037, Paris, Texas 75461. Board/CommiasionlCommittee of Interest ❑ Airport Advisary Board ❑ Building & Standards Gommissian , ❑ Givil Service Commission ❑ Economic Development Corporation ❑ Historic Preservarion Commission Housing Authority Board of Commissionexs ❑ Main Street Advisory Board Candidate Information ❑ Municipal Band Commission ❑ Paris/Lamar County Board of Health ❑ Planning & Zoning Cammissian [4'Public Library Advisory Board ❑ Traffic Commission ❑ Zoning Board of Adjustment Natrie: IPL b or a h N 0.-~ ~ e~1 Address: ~j 12- 5 D I eG- -i e-4 e r-Dr Work Phone: Home Phone: q' 03 Fax: q d 3 r7 $ 5-5&2q E-ma.il Address: a o c-(0 Sa d 41 e P) 1~ n k, r) e-+ Please note any special knowledge, education, or experience you ha.ve that is applicable to the fimetion of the board, commission, or committee of interest (attach additional pages if necessary). If applicable, list dates af service on any Gity boazds, eommissions, or committees. Certification and Authorization By signing below, I aclrnowledz,e 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 ceRify 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 posiuons on a given board, commission, or committee is luruted and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible futvre 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 disqualificaiion. I auThorize the City of Paris to verify all information provided in this application. Ln accordance with Section 552 of the Local Government Code, I understand that information provided in this applicationVVay be available to the public upon request. Signature of Candidate• / at,/ 1A/ Date: `f - /5- Of Fnr C'ifv. CIerk's Use Unlv - ; , . . - Conflict of Tnt'erest: _ Y 1 rT .Iade6tec~ness: Y! N l~epotism Y/ N~isC 1-.2 :3 4 5 6(7. 'reviou5 Set'vice ~ ~.102 3 4 5, 6: ~ City of Paris Revised 02119108 ~ l'd tiZ9598L£06 . 0U~223 AeI}eH paeyoi2! s£Z: 6 6 SO 9 6 jdb'