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Janice Ellis <br />From: support@civicplus.com <br />Sent: Tuesday, February 01, 2011 8:50 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 I Committee / Commission <br />The <br />First Narr*~ <br />A.' d <br />< <br />Address* <br />City* <br />P S <br /> <br />k <br />Tetephone <br />90 78315M <br />(903)1234667"' <br />' <br />% <br />~ <br />M001~~ <br />Areaas ofi 1 <br />istow " <br />e <br />l <br />~06 Coayltyfto <br />100 <br />W. <br />1 <br />~ Atd ,df ~ <br />Sttse# Advisclty Board <br />I acknawtetp that Ian Ovuare 8nd agree fiO the prok~bftns a#' the City of Parii <br />nepotism atd cortftts tf intetest o# appoWeOs fo CkEy boards, roffmiissiQns, s <br />attend at least 75 percent of aft regWar rnaebngs'and sftaN â–º^wt ftave sny de#irrqi <br />understartcf that the number af positons on a gtven Eoard, eotrntirission, at eam <br />however, if t am no# appainted, t agree to be pWted in s doWase fcu' possibie' <br />informatiorâ–º, gnren by me in this applic,ation is tnte ard canet artci any falsg infc <br />disqwalificaMan, i autlmrize tkue Gity of Paris to verify OIt 'rnformatlon provided irt <br />Loeal Govemment Cade, t undetstand tltiat infonnation provided in #hia aPPNca1 <br />[X] Agree <br />` indicates required fields. <br />[ ] Disagree <br />~ ~ 184 <br />