16-Deliberate and act on a Resolution appointing members to various boards, commissions, and committees

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BOARD/COMMISSION/COMMITTEE APPLICATION The Paris City Council is seeking conunitted 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 Counci]'s policy to appoint persons to a maximum of two consecutive full three-year terms on a given i Ube body. In addition to the general qualitications listed in the certification below, other quali~~ mandated by statute, City Charter, ordinance, or resolution. Please complete the informat below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 7546]. ~ ~~pf; Board/Commission/Committee of Interest Q'Airport Advisory Board ❑ Building & Standards Commission Ef-c-i'vil Service Commission ❑ Economic Development Corporation ❑ Historic Preseivation Commission ❑ Housing Authority Board of Commissioners ❑ Main Street Advisory Board Candidate lnformation N ame: oel 7V TP ❑ Municipal Band Commission S, ❑ Paris/Lamar County Board of Health ❑ Planning & Zoning Cammission ❑ Public Library Advisory Board [g-'P"raffic Commission ❑ Zoning Board of Adjustment Address: S3o~ t0 - E_ 3 3'_~ /'~ri~TeKas -71116,, Work Phone: A-~A Home Phone: ToLM-$S 3s' ee((' ~03--366.923y Fax: E-mail Address: v, ec4 15 S G ci n~P 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 necessaiy). lf applicable, list dates of service on any City boards, commissions, or cominittees. J, ~r.. S e i' ✓ i~ o~ '~"'✓b ~'i C C 9 c+1 i S'S o-~ c L ~ S 2.~ w. ~ C.~ /~e fo rn i!: K.ta , ~ w ~ r' ~ e . ~ . ~ s ei v, z ~ ~'.r.->1 [ o .r r ~ ~ L Y i~ e_z.ri a.,-~ Se°~vr.~ ~ d - Z c ~a.a l ~o 4c_ Y ~sv .f-~, i ~ r+: v. ~ j'r:r✓.2: ~~--Ala~~e s-~l f-4 = e"•`~-- o ~ f~' ? 6"~ r~ ~'i:..+-~a_ - Z 4-✓L 4 ~.9e~f ~ Ac• a N?~. .j' /?J qt G'i.✓~.J~v` i v`/,.C3L- rCiCS6~♦ ~~~f~a,i st+~'y1~s~~' Lee~ .r~BVC....~ l'4e ~~<'-2 GZ! r,L J~>'tN~IL fs~!%~ ~a,: l~i bGCKC /"~Le~Je Certification and Authorization 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 regarding nepotism and conflicts oF interest of appointees to Gity boards, commissions, and committees. I also certify that if appointed 1 will attend at least 75 percent of all regular meetings and shall not have any delinquent indebtedness to the City during my term. 1 understand that the number of positions on a given board, commission, or committee is limited and that I may not be appointed; however, if 1 am not appointed, I agree to be placed in a database for possible future notification of topies of interest. 1 certify that the information given by me in this application is true and correct and any false information or misrepresentation is sufficient grounds for disqualification. 1 authorize the City of Paris to verify all information provided in this application. In accordance with Section 552 of the Local Government Code, I understand that information provided in this applicatiotyynay~be available to thepublic upon requesC. Signature of Candidate: Date: G9- el?-- Z~=leoD For Cih Clerk's Use Onl Conflict of Interest: Y; N Indebtedness: Y/ N Nepotism: Y/ N Dist.: 1 2 3 4 5 6 7 Previous Service: 0 1 2 3 4 5 6 City of Paris 16P) Revised 08/19/08