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Janice Ellis <br />From: support@civicplus.com <br />Sent: Monday, May 16, 2011 12:18 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 J 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, commissiona, and committees. In general, n is the City Counci!'s pobcy to appofnt perspn$ to a maximum of two <br />consecutive futl three-year tertns on a given body. In addition to the general qualifications 11sted in tfie certification betow, other <br />qualifications may be mandated by statute, CiCy Charter, ordinance, or resolutlon. Please complete the information requested below. <br />First Name* Marilyn Laat Smith <br />Name' <br />Address' 844 14th N.W. <br />City' Paris State' TX ZiP" (x) 75460 <br />( ) 75462 <br />Telephone <br />(903)123-4567' <br />Areas of Interest" <br />Please note any special knowledge, education, or <br />experience you have that is applicable to the <br />functivn of the baard, commission, or committee of <br />interest (attach aciditianal pages if necessary). if <br />applicable, tist dales of senrice on any City boards, <br />commissions, or committees. <br />Certification and Authorization <br />903-784-5895 <br />75461 <br />Airport Advisary Board <br />Municipel Band Commission <br />[ l Bu►lding & Standards Commission <br />N Paris/Lamar County Board of <br />[ ) Civi1 Service Commission <br />Health <br />[X} Economic pevelopment <br />(xl Planning & Zoning Commission <br />Corporation <br />[ j Publtc Library Advisory Board <br />[ J Hfstoric Preservation Comrrrission <br />f I Traffic Commission <br />Housing Authority goard of <br />[xJ 2oning Board of Adjustment <br />Commissioners <br />[ j Street Advisory Board <br />May 12th Graduate af Lamar County Leadership <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 cortflicts of interest of appointees to Ciry boards, commisslons, and cammittees. I also certify that if appointed I witl <br />attend at teast 75 percent of all regular meetings and shall not have any detinquent indebtedness to the City during my term. I <br />understand that Ehe number of positions on a given board, commission, or committee is limited and that I may not be appanted; <br />however, if I am not appointed, I agree to be plaeed in a dahabase for <br />information given by me in this appGcation is true and corcect and any fat~sel~tnformabo~ Q~r~m'~t~~ of topies of interest, l certify that the <br />disqualtficatian. I authorize the City of Paris to verify aq infom►atfon provided in this apptication,~In~ aecordance with Secti n 552 f the <br />Local Govemment Code, I understand that information provided in this application may pe ava8able to the public upon request.' <br />[XI Agree <br />' indicates required fields. <br />The following form was submitted via your website <br />( ] Disa9ree <br />Application for Boards / Committee / Commission <br />12 5' <br />