15 Appointment to boards, commissions and committees

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BOARD/COMMISSION/COMMITTEE APPILICATION The Paris City Council is seeking committed individuals who are dedicated to the well-being of the Paris community to serve on its standing boards, commissions, and committees. In general, it is the City Council's policy to appoint persons to a maximum of two consecutive full three-year terms on a given body. In addition to th , general qualifications listed in the certification below, other qualifications may be mandated by statute, ity Charter, ordinance, or resolution. Please complete requested below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texasv*"d Board/Commission/Committee of Interest ❑ Airport Advisory Board ❑ Building & Standards Commission ❑ Civil Service Commission ❑ Economic Development Corporation ❑ Historic Preservation Comrnission ❑ Housing Authority Board of Commissioners ❑ Main Street Advisory Board Candidate Information t,u';~ 1 7 2008 ❑ Municipal Band Comn*~f paris tK Paris/Lamar County BoazCANNih ❑ Planning & Zoning Commission ❑ Public Library Advisory Board ❑ Traffic Commission ❑ Zoning Board of Adjustment Name: f -F o u Address: 40 a~-0 C l 4 lr kS v t~t e, Work Phone: q- 0 3 ) Y~F 3$ 7 Fax: q o'> 7Y"P 3 7 3- TY Home Phone: q a 3 1 YY '7'S7 3 E-mail Address: c,__ Certification and AutLorization 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 State of Texas regazding nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also certify 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 positions on a given board, commission, or committee is limited and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible future notification of topics of interest. I certify that the information given by me in this application is true and conect and any false information or misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify all information provided in this ap catio In accordance ' Section 552 of the Local Government Code, I understand that information provided in this ap icatio ' be a' le the lic upon request. Signature of Candic~ate: Date: Ct/i v For Citv Clerk's IIse Only Conflict of Interest: Y/ N Iqdebtedness: Y/ N Nepotism: Y/ N Dist.: 12 3 4 5~Previous Sexviee %12 3 4 5 6 City of Paris 000233 Revised 02/19/08 Please note any special knowledge, education, or experience you have that is applicable to the function of the board, commission, or committee of interest (attach additional pages if necessary). If applicable, list dates of service on any City boards, commissions, or committees.