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BOARD/COMMISSION/COMMITTEE APPLICATION <br />The Paris City Council is seeking committed individuals who are dedicated to the well-being of the Paris <br />conununity to serve on its standing boards, commissions, and committees. In general, it is the City <br />Council*s policy to appoint persons to a maximum of two consecutive full three-year terms on a given <br />body. In addition to the general qualifications listed in the certification below, other qualifications may be <br />mandated by statute, City Charter, ordinance, or resolution. Please complete the information requested <br />below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas 75461. <br />Board/Commission/Committee of Interest <br />❑ Airport Advisory Board <br />❑ Building & Standards Commission <br />❑ Civil Service Commission <br />❑ Economic Development Corporation <br />❑ Histor:c Preservation Commission <br />❑ Housing Authority Board of Commissioners <br />❑ Main Street Advisory Board <br />Candidate Information <br />VMunicipal Band Commission <br />❑ Paris/Lamar County Board of Health <br />❑ Planning & Zoning Commission <br />❑ Public Library Advisory Board <br />❑ Traffic Commission <br />❑ Zoning Board of Adjustment <br />Name: Rh D V1 cJl c~ I_ I0,'' y' LS <br />Address: ) g 30 3C5~~- N2~_- <br />Work Phone: 16 q D 3 - ~ 9 / ' ~ ~ 9 tp Home Phone: 11- D3 - ~ g ~5 ` <br />Fax: - <br />E-mail Address: rh oh Ao~ ~ 1M nrr~ c7 0, vhc1; G ovr~ <br />Please note any special knowledge, education, or experience you have that is applicable to the function of <br />the board, commission, or committee of interest (attach additional pages if necessary). If applicable, list <br />dates of service on any City boards, commissions, or committees. <br />1 <br />~lea rS e.xL neri -Q/VN c _Q_ aS c <br />Certification and Authorization <br />I3y signing bclow, I acknowledge that I am aware and agree to the prohibitions of the City of Paris Charter and the laws of tlle <br />Siate of Texas regarding nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also <br />certify that if appointed I will attend at least 75 percent of all regular meetings and shall not have any delinquent indebtedness <br />to the Cily during my term. I understand lhal the numher of positions on a given board, commission, or committee is limited <br />and that I may not be appointed; however. if I am not appointed, I agree to be placed in a datahase for possible tuture <br />notification of topics of interest. I certify that the information given by me in this application is true and correct and any false <br />information or misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to veril'y all <br />information provided in this application. In acaordance with Section 552 of the Local Government Code, I understand that <br />information provided in this application may he available to the public upon request. <br />Signature of Candidate: ~~4~.r•d~a-- rmvo~~ Date: 2- L- I l <br />For C_ity Clerk's Use Onlv <br />City of Paris <br />~UL 0 8 2010 <br />QJ11M <br />N Indebtedness: Y/ N Nepotism: Y/ N Dist.: 12 3 4 5 6 7 Previous Service: 0 1 2 3 4 5 6 <br />Revised 08/19/08 <br />~ <br />