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 Cotmcil 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 ternis on a given body. In addition to the general qualifications listed in the certification below, other qualifications may be maudated by statute, City Charter, ordinance, or resolution. Please complete the information requested below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. Board/Commission/Committee of Interest ❑ Airport Advisory Board fA Building & Standards Commission VF'41 Civil Service Commission ❑ Economic Development Corporation ❑ Historic Preservation Commission ❑ Housing Authority Board of Commissioners ❑ Main Street Advisory Board Candidate Information ❑ Municipal Band Commission ❑ Paris/Lamar County Board of Health ❑ Planning & Zoning Commission ❑ Public Library Advisory Board ❑ Traffic Commission ❑ Zoning Board of Adjustment Name: I/ Address: A0 A~X 6a'I'_3 S-W-qPhone: 9Uj Home Phone: 46 r16 Fax: E-mail Address:~ ~1 .OursF~j~~~,~ 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. ~_dJe+F~^~'~Y '4C" iGf,p'J Uei' le- GY1-'s4- d-1~ ~96 u.e,r/. 44 mo'of ' ~/7.,c~fi3rA -4 ~1~'IK ~~7dUQ-~O✓1 G ~ 6ti/' LlJf/ /'S~J4.~'y /•~17f~ ICM.~~1L~s ~ ~/`~19' 1' .Pf. 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 City boards, commissions, and committees. 1 alse 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 dttring nry 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 1 am not appointed, ] agree to be placed in a database for possible future notification of topics of interest. ] certify that the inforniation given by me in this application is true and correct and any false infoi-mation or misrepresentation is sufficient groimds for disqualification. I authorize the City of Paris to verify all information provided in this a plica on. In accordance with Section ~~2 of the Local Government Code, I understand [hat information provided in th , ap lic ~on may b avail ble to the public upon request. Signature of Candida : Date: ~AG/a For Citv Clerk's Use Onlv 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 Revised 08/19/08 lft,aZp "'4 1 TIC Certification and Authorization