14-Deliberate and act on a resolution filling an unexpired term on the Airport Advisory Board

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BOARD/COMMISSION/CCIMMITTEF APPLICATION The Paris City Gouncil 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 ta a maacimum of two consecutive full three-year terrns on a given body. In addition to the general qualificatians listed in the certification below, other qualifications may be mandated by statute, City Charter, ordinance, or resolution. Please complete the information requested belaw and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas, 75461. Board/Commission/Committee of Interest 0 Airpart Advisory Board ❑ Building & Standards Commission ❑ Civil Service Commissian ❑ Economic Development Corporation ❑ Historic Preservation Commission ❑ Housing Authority Board of Commissioners ❑ Main Stzeet Advisory Board ❑ Municipal Band Commission ❑ ParislLamar County Board of Health ❑ Planning & 2oning Commission ❑ Public Library Advisory Board ❑ Traffic Commission ❑ Zoning Board of Adjustment Candidate Infarmation Name: < Ve Q.~211161, Y't Address: Work Phane: Home Phone: Fa.x: E-mail Address: Please note any special knowledge, education, or experience you have that is applicable to the function of the board, commission, or cammittee of interest (attach additionat pages if necessary). If applicable, list dates of service on any City boards, commissions, or committees. ~W FXec. 0)+2. J A~5D G. ForrnPr (6kj /llccn49e, rw) ~-h r'e'S4ohs,'b•L~'y q S Aor7" D,huc~*r-. FttA ~.1-i it n c) e~f,.s ~r'~c. f ~ b r. a a t e-~~..ez.•~ ~ Certification and Authorization By signing below, I acknowledge that I am aware and agree to the prohibitians 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, commissians, 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 lixnited and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible future notificatian of kopics 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 atl information provided in this applicaon. In accordance with Section 552 of the Local Govemment Code, I understand that informatian provided in this applicpi4jn may be 4§ilable to the public upon request. Signature of Date: IA `j ' a q Fnr C'ity f`I@g Ila QP ConlllcE of 1'nterests 'iT / N Indebteduess. Y f N Neponsm: Y 1 N DIst.: 12 3 4 5 b 7 Prevlous Servlce: Q 12 3 4 5 6 City of Paris Revised 02/19/08 - 122,