17-Resolution appointing members to the various Boards, Commissions and Committees

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BOARD/COMMISSION/COMMITTEE APPLICATION The Paris City Council is seeking committed individuals who are dedicated to the well-being of the Paris community to serve on its standing boards, commissions, and committees. In general, it is the Gity Council's policy to appoint persons to a maximum of two consecutive full three-year terms on a given body. In addition to the general qualifications listed in the certification below, other gualifications inay be mandated by statute, City Charter, ordinance, or resolution. Please complete the infonnation requested below and return to: City Clerk, 150 SE First Street/P.O. Box 9037, Paris, Texas, 75461. Board/Commission/Committee of lnterest Airport Advisory Board ❑ Building & Standards Commission ❑ Givi] Service Commission ❑ Economic Development Corporation ❑ Historic Preservation Commission ❑ Housing Authority Board of Commissioners ❑ Main Street Advisory Board Candidate Name: MAY 6 r~m11o21 ❑ Municipal Band Commission ❑ Paris/Lamar County Baard of Health ❑ Planning & Zoning Cominission ❑ Public Library Advisory Board ❑ Traffic Coininission ❑ Zoning Board of Adjustment Address: Z IJ ON H;-I1/jR St I S Work Phone 0 3 `f - E q ~Y Home Phone: 7s116 0 Fax: (9"0J?Y7e~' 2_~_03 E-mail Address: P-Krk'kXCcS~ 0 i4l Please note any special knowledge, education, or experience you have that is applicable to the function of the board, commission, ar committee of interest (attach additional pages if necessary). If applicable, list dates of service J any City boards, cornmissions, or committees. , , ~ we nd . Y fi i I ~ r~ ~ t~ ,J+f,~or~ ~d- 1~. s t S T 1~ Gt ~ ~-1'?. ~f j eY' a h C` ~a h r ~ reE' ,Y' a b n_h yit,w W wld ee Ptc ~ -t~C S Pz. p L -r .a 'I' I'll, -f;) f).-,.-) eco.'►om i r ta;-0h *~e Certification and Authorization By signing below, 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 nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also certify that if appointed T will attend at least 75 percent of all regular meetings and shall not have any delinquent indebtedness to the City during my tenn. I undei-stand that the number of positions on a given baard, conunission, or committee is limited and that I may not be appointed; however, if I am not appointed, I agree to be placed in a database for possible future notification of topics of interest. I certify that the inforniation given by me in this application is true and correct and any false infornlation ar misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify all information provided in this applic . ln accor ance with Section 552 of the L,ocal Government Code, ] understand that information provided in this appli t' ay be a ilab o the public upon request. Signature of Candidate: Date: For Cfty Clerk's Use Onlv Conflict of Interest: Y/ N Indebtedness: Y/ N Neporism: Y/ N Dist.: 1 2 3 4 5 6 7 Previous Service: 0 1 2 3 4 5 6 City of Paris - - 181 Revised 02/19/08