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Janice Ellis <br />From: support@civicplus.com <br />Sent: Thursday, October 29, 2009 5:45 PM <br />To: Janice Ellis; Denene Taylor <br />Subject: Online Form Submittai: Application for Boards/Committee/Commission <br />If you are having problems viewing this HTML email, click to view a Text version. <br />Application for Boards/Committee/Commission <br />The Paris City ~una~ ts seeking co~mt»itied individuals v~rho are declirated to the well-teing of the Paris eommuntly:lo serve ora its <br />staraling bo~ar~; camrW'ssion's.` and c3ommittees:in gerfseral, it is the Cifiy Cauncit's poticj+ tta appoEnt personsto.a ~di~~'of h+~ <br />ct~nsecutive f~ ,-year,te~s on a glven body. !n addifron ta the general qualificafior~ listed in the cert~ica~r►1~e~v, er ; <br />quaiificaUons rkay be`martdated by statute, City Char#er, ordlnance,'or resolu#ion. Please cDmpiete the lttfbrrwition'reqWdvu. <br />First Narne`' : <br />Fred Last Williams <br /> <br />w, <br />; `Yamek . . <br />Addrese <br />6480 Hwy 79 ' <br />City* <br />Sumner Sta#e'" TX ZiA* 7,4460 <br />(X) 75462 <br />75461 <br />Telephone <br />9D3 782 9419 <br />(903)123=4567* <br />(X1,A'uport Advisory Board - <br />L ] Mursi ctpal B~i~d~r~issior►. <br />Areas o# Interest"' <br />8uifding & Standards Commis'sion <br />ParisfLa~raar Co~~j± Board df <br />C l Civi1 Setvice Commission <br />He;lfh.. <br />I l Economic Qevelopment ~ <br />I] PEat~r~ir~~~ Zoruti~ ~ommistion <br />Corpar~#ten <br />[ l Puiigc Library~ ~A~iviipry ~aord <br />' <br />[ l Hts#oric Preservation Cornr~issit~r~ <br />r~aissior~ <br />[l Traffic Cc~r <br />[ j Nirusing Awthority Board of <br />I l Zoning Board oiAd}ustmen# <br />Cornrrtissioners <br />~ l Sireet Advisory Board <br />Please note aity speciat kncmrledge, educa#lon, or <br />Pilot, alrcrafl bwilder and mechanic. Physic3art. Have tny airplane hQUSetI a# <br />experience you have that is applicable to tMe <br />Paris Cox Fieid. Correct zip code 75486 <br />function of the 4oard, commissivn, or comrnittse of <br />inferest (attach"additiorra! pages if necessary), tf <br />applicable, list da#es af service on any City baards, <br />commissions, or corntWittees, , <br />Certifiiicafion and Aut#ia`n,zatiara <br />I adcnawtedge;that l.arn aiware and agree to the prohibi#ians o# the City of Paris Charter and #he iaws af the S#ate af Texas regardfrag ' <br />nepo#i5m and r.onflfcts df intsre5i of apppintees to City boards, txommissions, and commit#ees. I also certify #ha# if appo1~tiid 1 wiil <br />afterid at ieast<`75 percent of a11 regu}ar m, ee#ings and strafl not hatie any delinquent indebtsdness to the Ch;d~tring mytst~.1. <br />unde~tand tl'at ~e i~umber df positiuns on a given bQard, aommission, or commitEee is itrrtlti:d a~►d ~at t tr~ay riot t~e appotnted; <br />hflwever, if 1 arn not appainted, ! agree tfl be'placed in a database for possible future nofifica#ion of fopics bf intereist.1 cerlify #fiat the <br />infamaatit}ii given by tnE"iti tttis application is true and correcf and any fialse information or tnisrepreseritation is st.tlfciE;n#;griur~ds #or ; <br />disqualifica#?an. l.aufhr~rize the City af Paris to verify a11 infc~nnafiior~ provided in this application. ln accordance inrifh Sectwri 552 of the <br />Local Governrnen# Code, I understand that information prvvicfetl in this application rnay be avaitable to 1he puba:uponrequesf." <br />P(I A9ree Il Disagree <br />* indicates required fields. <br />The following form was submitted via your website: Application for Boards/Committee/Commission <br />123 <br />