Laserfiche WebLink
Janice Ellis <br />From: support@civicplus.com <br />Sent: Tuesday, May 17, 2011 1:20 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 emai l, click to view a Text version. <br />Application for Boards / Committee / Commission <br />The Paris City Council is seeking committed 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 Councii's policy fo appoint persons to a maximum of two <br />consecutive ferM three-year teans on a given body. In addition to the general qualiflca#ians fisted in the certification befow, other <br />qualifications may be mandated by statute, City Charter, ord'mance, or resolution. Piesse complete the information requested below. <br />First Name" john Last pendleton <br />Address' <br />City' <br />Telephone <br />(903) 123-4587' <br />Areas of Interest" <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 additional pages if necessary). If applicable, <br />list dates of service on any City boards, commissions, <br />or committees. <br />Certification and Authorization <br />Name* <br />475 31 st se <br />Paris State" TX Zip" (X) 75460 <br />75461 <br />75462 <br />9037845832 <br />Airport Advisory Board <br />[X] Building & Standards <br />Commission <br />[ ] Civil Service Commission <br />[X] Economic Development <br />Corporation <br />[X] Historic Preservation Commi$sion <br />[X] Housing Authority Board of <br />Commissioners <br />[ ] Street Advisory Board <br />[ J Municipal Band Commission <br />[ ] Paris/Lamar County Board of <br />Health <br />[ ] Planning & Zoning Commissfon <br />[X] Public Library Advisory Board <br />[ ] Traffic Commission <br />[ J Zoning Board of Adjustment <br />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 <br />nepotism and conflicts of interest of appointees to City boards, commissions, and commi#tees. I also certily that if appointed I will <br />attend at least 75 percent of all regular meetings and shall not have any detinquent indebtedness to the City during my term. I <br />understand that the number of positions on a given board, commission, or commit#ee is limited and that I may not be appointed; <br />however, if I am not appointed, I agree to be placed in a database for possible future nofifieation of topics ofi interest. I certify that the <br />inforrnation given by me in this application is true and carect and any false infonnation or misrepresentation is sufficiertt grounds for <br />disqualification. I authorize the City of Paris to verify all information provided in this application. In accordance with Section 582 of the <br />Local Govemment Code, I understand that information provided in this application may be available to the public upon request.' <br />[X] Agree <br />` indicates required fields. <br />[ J Disagres <br />The following form was submitted via your website: Application for Boards / Committee / Coinmission <br />1]12 <br />