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Janice Ellis <br />From: support@civicplus.com <br />Sent: Wednesday, April 27, 2011 11:22 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 />Appiication for Boards C Committee / Commission <br />The Paris City Gouncil is seeking committed individuals who are dedicated to the weH-being of the Paris community to serve on its <br />standing boards, commissions, and committees. In general, it is the City Council's policy to apppint persons to a maxtmum of two <br />consecutive fuN three-year terms on a gtven body. In add+tion to the general qualifications listed in the cerpfication below, other <br />qualifications may be mandated by statute, City Charter, ordinance, or resolution. Please complete Che information requested below. <br />First Name" David Last Stewart <br />M Name" <br />Address` P.O. @ox 2 <br />City# Petty State' TX. Zip' (X) 75460 75462 <br />75470 O 75461 <br />Telephone 903-517-4248 <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 />function of the board, commission, or committee of <br />interest (attach additional pages if necessary). If <br />applicable, list dafes af service on any City boards, <br />commissions, or committees. <br />Certification and Authorization <br />I l airPart Advisory Board Municipal Band Commission <br />Building &Standards Commission Paris/Lamar County Board of Health <br />C1viE Service Commission [ J Ptanning & Zoning Commission <br />[ j Econamic Development [ I Public Liixary Advisory Board <br />Corporation [ ] Traff'►c Commission <br />[X] Historic Preservation Commission ~ lZoning Board of Adjustment <br />[ ] Housing Authority Board of <br />Commissianers <br />[ ] Street Advisory Board <br />I have owned a historic building at 123 CtarksvHte for the last 2 years. In those 2 <br />years, I've been before the commission on behaff of my building in order to make <br />repairs and improve the fagade, giving m8 knowledge of procedures necessary <br />to affect the preservation of my buitding <br />I acknowledge that 1 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 committees. I also certify that if appointed I wiH <br />attend at least 75 percent of all regular meetings and shafl not have any delinquent indebtedness to the City during my tertn. I <br />understand that the number of positions on a given board, commission, or committee is limited and that I may not be appointed; <br />however, if I am not appointed, I agree to be placed in a database far possible future notiflcafion of topics of interest. I certify that the <br />information given by me in this application is true and correct and any false information or misrepresentation is sufficient grounds for <br />disqualficatlon. ! authorize the Ciry of Paris ta verify all informatian provided in thts application. In aceordance with Section 552 of the <br />Locaf Govemment Code, I understand that infortnation provided in this application may be available to the public upon request." <br />[X] Agree <br />" indicales required flelds <br />[ J Disagree <br />The following form was submitted via your website: Application for Boards / Committee / Commission <br />i <br />127 <br />