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BOARD/COMMISSION/COMMITTEE APPI..ICATION <br />The Paris City Council is seeking committed individua.ls 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 thg, general qualifications listed in the certification below, other qualifications may be <br />mandated by statute, City Charter, ordinance, or resolution. Please complete the inforr~ftd&rV3L-UQ <br />below and reiurn to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. <br />Board/Commission/Committee of Interest <br />APR 2 5 2008 <br />2 Airport Advisory Board <br />E~F 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 />Candidate Information <br />Name: 12fmVeS " A,( Te r- <br />Address: ut120 51+wN0oo 'Utz • <br />Work Phone: 9 03 '18 S o3 03 Home Phone: go3 185 %S(64 <br />Fax: °10'3 '186 0308 E-mail Address: 2tta%Tme ►~~YSr~cE~v~a~r~ua~~ac,.caw~ <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, coxnmissions, or committees. <br />Po«. m - &o~ geww~r.. <br />Imae zooa <br />Certification and Authorization <br />❑ Municipal Band Commission C' Of Paris <br />Paris/Lamar County Board of Hei Cierk <br />❑ <br />Planning & Zoning Commission <br />❑ Public Library Advisory Boazd <br />❑ Traffic Commission <br />v❑"'Zoning Board of Adjustment <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 tnte and correct and any false <br />information or misrepresentarion is sufficient grounds for disqualification. I authorize the City of Paris to verify all <br />information provided in this~gpationl~;In accordance with Section 552 of the Local Government Code, I understand that <br />information provided in this pplic tion may be avai~able to the public upon request. <br />Signature of Candidate: <br />Date <br />y•tis-ob <br />For Citv C1erk's Use On:lv t ~ <br />Conflict of Interestc Y/ N Ind,ebtedness: Y/ N Nepotism: Y/ N Dist.: 12 3 4 5 6 7 Previous Service: 0 1234 5 6 <br />City of Paris Revised 02/19/08 <br />: Utl0 22`3 <br />