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BOARD/COMMISSION/COMMITTEE APPLICATION <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, coimnissions, 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 the general qualifications listed in the certification below, other qualifications inay be <br />inandated by statute, City Charter, ordinance, or resolution. Please complete the information reyuested <br />below and retum to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas, 75461. <br />BoardlCommission/Committee of Interest <br />0 Airport Advisory Boazd <br />❑ Building & Standards Commission <br />2f Civil Service Commission <br />❑ Economic Development Corporafion <br />❑ Historic Preservation Commission <br />❑ Housing Authority Board of Commissioners <br />❑ Main Street Advisory Board <br />Candidate Information <br />Name: <br />ele <br />❑ Municipal Band Commission <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 />Address: 5~r, <br />Work Phone: "_/0 3 - 3(16 - V 2 3 ly- Home Phone: ?8 4 - 2 ?15' <br />Fax: 'Fo 3 ? Y4 - s 3 3 S E-mail Address: ,reA t ss Q> ,4e f- <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 />~cw 5~✓U:15 SS; c•.a. W",,(„P bc ~.n~~~~)'f e.✓l ~c=/'[/:cG <br />`O~?/K! SJ/ ~-~1 4-.cr~ il~o!!- c+r✓Sc/Y ~U4.r~ <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 boazd, conunission, 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 inforniation 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 a11 <br />information provided in this application. In accordance with Section 552 of the Local Government Code, I understand that <br />information provided in this application may e available to e public upon request. <br />Signature of Candidate: - Date: ~Zvl <br />or Cttv Clerk's Use Onlv <br />Conflict o! interest: Y/al Indebtedness: Y/ Nepotism: Y/(& Dist.: l 2 3 4 5 E6 Previous Service: 0Q2 3 4 5 6 <br />City of Paris Revised 02/19/08 <br />Pr~f;11-1 <br />