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Janice Ellis <br />From: support@civicplus.com <br />Sent: Wednesday, May 11, 2011 3:16 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 City Council is seeking committed individuats who are dedicated to the well-being of the Paris community to seroe on its <br />standing boards, commissions, and committees. In general, it is the City Council's policy to appoirtt persons to a maximum of two <br />consecutive ft,ll three-year tertns on a given body. In addition to the generai qtiafMcations fisted in the certiFication bebw, othEr <br />quaGfications may be mandated by statute, City Charter, ordinance, or resolution. Ptease complete the ir►formation requested below. <br />First Name` Donnie Last Neisfer <br />Name' <br />Address' 815 S. Coltegiate Dr <br />City' Paris State" TX Zip' (X) 75460 75462 <br />75461 <br />Tefephone <br />(903)123-4587' <br />Areas of Interesf' <br />Please note any special knowledge, education, or <br />experience you have that is applicable to the function <br />of the board, commission, or committee of interest <br />(attach addifional pages if necessary). If applicable, <br />list dates of service ort any City boards, <br />commissions, or committees. <br />Certification and Autharization <br />(903) 249-7777 <br />[ ) Airport Advisory Board <br />[ ] Buitd'rng & Standards Commission <br />[ j Civil ServiEe Goenm'tssiort <br />[ ] Economic Development <br />Corporation <br />[ ] Historic Preservation Commission <br />[ ] Housing Autho►ity Board af <br />Commissioners <br />( ) Street AcfviSOry Board <br />[ ] Municipal Band Commission <br />[ J ParislLamar County Board of <br />Health <br />[ ] Planning & Zoning Commission <br />[ j Public Library Advisory Board <br />[X] Traffic Commission <br />[ I Zoning Board of Ad}'ustment <br />I acknowledge tha! I am aware and agree to the prohibitions of the City of Paris Charter and the laws of the State of Texas regarding <br />nepotism and conflicts of interest af appointees to City boards, commissions, and commitises. I also certify that if appointed I will <br />attend at least 75 percent of all regular mee6ngs and shafl not have any deNnquent indebtedness to the City during my term. 1 <br />understand that the number o# positions on a given board, commission, or committee is limited and that I may not be appointed; <br />however, if I am not appair►ted, I agree to be, placed In a database for possible future notification of topics of interest. I certify that the <br />information given by me in this application is true and comect and any false infortnation or misrepresentation is sufficient grounds for <br />disqualification. I authorize the City of Paris to verify all infoimation provided in this applicalion. In accordance with Section 552 of the <br />Local Govemment Code, I understand that information provided in this appkcation may tae available to the pubtic upon request.' <br />[X] Agree <br />' indicates required fields <br />[ J Disagree <br />The following form was submitted via your website: Application for Boards / Committee / Commission <br />106 <br />