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Janice Ellis <br />From: support@civicplus.com <br />Sent: Thursday, May 05, 2011 7:57 AM <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 City Council is seeking cotnmitted individuals who are dedicated to the well-being of the Paris community to serve on its <br />standing boards, commissions, and committees. In general, it is the City CounciPs poliey to appoint persons to a maximum of two <br />consecutive fuN three-year teems on a given bady. In addi#ion to the generat qualitications Msted in the certlfication betow, other <br />qualifications may be mandafed by statute, City Charter, ordinance, or resoluUon. Please camptete the infomTation requested below. <br />First Name' Billy Last Copeland <br />Address" <br />City' <br />Telephone <br />(903) 123-4567* <br />Areas of interest` <br />Please note any special knowtedge, education, or <br />experience ydu have that is applicable to the <br />function of the board, commission, or committee of <br />interesl(attach additional pages if necessary). If <br />applicable, list dates of service on any City boards, <br />commissions, or committees. <br />Certification and Authorizatian <br />Name' <br />143 CR 36450 <br />ArthurCity State* <br />(903) 732-3468 <br />TX Zip' (X) 75480 ( ) 75462 <br />75461 <br />[X] Airpo+t Advisory Board <br />Municipa! Band Commission <br />Buiiding & Standards Commission <br />[ l ParislLamBr Caunty Board of Heafth <br />[ l C€vit Serv+ce Commission <br />f~ Planring &Zatdng Commission <br />[ J Economic Development <br />L l Puhfic Library ftdvisory Board <br />Corporation <br />[ j Trafic Commission <br />F+istoric Preservatiort Commission <br />[ IZoRing Board a# Adjustment <br />[ ] Housing Authority Board of <br />Cornmissioners <br />[ ] Street Advisory Board <br />Have served on the board a prior term and have experiance on issues. Also <br />attend open meetings training. Note : above zip code needs to be 75411 <br />I acknowledge that i am aware and agree to the prohibitions of the City of Paris CharEer and the laws of the 5tate of Texas regarding <br />nepotism and coMficts of interest of appoirytees to City boarcts, commissions, and comenittees. I also certity that if appointed I wiii <br />attend at least 75 percen# of all regular meetings and shall not have any delinquent indebtedness to the Gity during my term. I <br />understand that the number of positions on a given board, commission, or committee is limited and that 1 may not be appoiMed; <br />however, if I am not appofnted, I agree to be placed in a database for possibfe future notification of topics of interest. I certify that the <br />information given by ma in this applicatian is true and cornect and any false irtformation or misvepresentation is sufficient grounds for <br />disqualificatioR. I authorize the City of Paris to verify all information provided in this appticatian. In accofdance with Section 552 of the <br />Local Govemment Code, I understand that information provided in this application rnay 6e availabte to the public upon request." <br />[X] Agree <br />' indirates required fields. <br />Disagree <br />The following form was submitted via your website: Application for Boards I Committee / Commission <br />84 <br />