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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 Submittal: 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 Gity Cauna1 ts.SeeKing cqtnmitteci indiwidualss who are dedicated to the well-treing of the Paris commut►ity €p serve on its <br />stantiing boatdg, commissions, and `comrnittees. tn gener°af; it is the City Cauncil's palicy to' apPaint persor~s.to ;a t'n~inurn.'of two' <br />consecutive'ful! three-~year Eerms oa~ a given body. In adtlititsn to the gsneral q~ralificatians fisted in the certFficatian' belo4v,,other <br />qualifca#ions inay be tttandatetl by s#afute, City Charter, ardinance, or resotution. Ptease complete the Erifoffnatinn requested below. <br />First Name' ` Fred Last Witliams <br />Narne* <br />Address' 6480 Hwy 79 <br />City* Sumner State* TX Zip* 75460 (X) 75462 <br />O 75461 <br />Telephone 903 7$2 9419 <br />(903) 123-4567* : <br />[X] A►rport atlvisory Board IWunicipal Band; Cflrrirnission <br />Areas of In#ei'est* Building & Sfandards Commission { I;Paris%Lamar Courity Qqaird of . <br />[ ] Civil Serrrice Gommission Heatth <br />[ l Economic Development [ l Plan~i(tg-& Zcning. Corrrmission <br />Corporation [ l Pua}ic Lihrary Adwisory 'Board ~ [ a t-tistoric Preservatian Commission f) Traiffic Corrtmission <br />[],Housirtg Authority Board of I I Zoning Board of Adjustrnent <br />Commissioners <br />[ ] Street Advisory Board <br />Please note any special knowledge,'education, or Pilo#, aircraft birilder and mechanic. Physician. Have my airplane houseci at <br />experience you have that is applicabls to the Paris Cox Fiehd, Correct zip eode 75486 <br />functien of the board, corttmissiQn; or cornmittee of <br />interest (attach additional pages i# necessary). If <br />applicabfe, list dates of service on any City boards, <br />commissions, ar carr►mittees. ` <br />Certificatian and Authorization <br />I acknowledge fhat I:am aware and agree to the prohbitions of the City af Paris Charter and the laws of the State of Texas regarding <br />nepotism and carr#ficts of interest of appointees to Gity boards, commissions, and committees. I also certify thai i# appainEed I witi <br />after►d At teast 7&percent af alt regular meetings and shaU not have any delinquent indebtednESS to the City during my terrn. I <br />understand'that the number'of positions on a given board, `commission, ar committee is limited and that ! may nqt be appofnted; <br />however, if I am not appointed, I agree to be placed in a database for pQSSible future nofification o# tapirs of irtterest. I cerfify that the <br />in#ormatian given by' me irr this apptication is trve and correct and any false information ar rrs{srepresentation is sufficient grounds for <br />disquafification. I authorize the City of Paris Eo veri#y al1 information prouided in this application. In accardance with Sectian 552 of the <br />Local Gavemment Cade, I understand tha# information provicted in this application may be available to the public upon request* <br />[XJ Agree <br />* indicates required fields. <br />[ ] Disagree <br />The following form was submitted via your website: Application for Boards/Committee/Commission <br />187 <br />