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Janice Ellis <br />From: support@civicpius.com <br />Sent: Friday, May 13, 2011 11:46 AM <br />To: Janice Ellis; Denene Taylor <br />Subject: Oniine Form Submittai: 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 / Committee / Commission <br />The Paris CKy Counal is sseking committed indiuiduals who are dedicaW tu the mll-boft a# ft <br />standing bes►rds, comfftissiorts, and cc»tmiltees. In , k is the Ci3y Ctauncit's p€'fty Eo a y <br />consecutive f'trH thrwyear terms em a glrren body, In addWw to the gonwW qtalifi ns Ksted Nrr i <br />qualificatiors may be mancfated by statute, G#ty Charter. otdinance, or rescylution. Pime campiefe <br />First Name* .featt L2Est Sehweers <br />hisme* <br />Address* 5005 Old Claricsvi#e Roerd <br />City'" Raris Sta#e'" 'fX Zip* 75460 <br />( ) 75461 <br />Telephone <br />(903)123-4567* <br />Areas of Interest"` <br />Please note any special knowlecige, education, or <br />experience you haue that is applicabie to the function <br />of the board, commissiun, or committee of interest <br />(attach addftional pages if necessary). If applicable, <br />list dates of service on any City boards, commissions, <br />or committees. <br />Certification and Authorization <br />(903)737-8409 <br />r <br />k..r <br />tXj 75482 <br />[ lA+rPod Advrsary Boarci [ I Munici{W 8end Comrrdssiom <br />[ j Budding & StandWrtis Commission [ I Parisl..arrlO€ COLmly Eloard of <br />[ l Givii Service Comrrdssion Heat#h <br />[ l Economic Qevalapmsnt L I Rlanning & Zcinir►g CommissiQn <br />Corporatian [ l PtbJic k.ibraryr Afwiwry Baard <br />[ l Historic Preservation Commrrgssion N Traffic Commissican <br />i 1Housing Authority Bc►ard af [ I Zaning Baard ctf Adjustmen# <br />Commissioners <br />I 1 Street Advisory Board <br />I studied Civif Engineering far three ysars befare completing a Bachelor of <br />Science degree in Psychology. Fcsr fun, J am swrer►tty tadcing classes a# PJC <br />with my last high scMool-aged homeschooied daughter and am ready ta <br />beeome involved fn improving the aty a# Paris. <br />I acknowledge tha# I am aware and agroe ta the prohibitions af the City of Paris Chatter and the laws of the State of Texas regarding <br />nepotism and conflicts of interest af appaintees to City boards, commissions, and committees. t also certifyr that if appanted I witl <br />attend at least 75 percent of all regular meetings and shatl rto# have any detinquent [ndebtedness tu ihe City during my term. I <br />understand that the number of positions an a given boarct, eommissian, or committee is limited and that I may not te appointed; <br />however, if I am not appointed, 1 agree to be placed in a dabbase for possible future natification of topics of interest. t certity that the <br />information given by me in this apptication is tnae and eorreci and any fafse infbrma#ion or misrepresen#a#ion is suffieient grounds for <br />disqualificafion. I authorize the City of Paris to verify all infa(mation provided in this applicatian. In accardance with 5ection 552 of the <br />Local Govemment Code, I understand that information provided in this application may be availab{e 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 / Commission <br />e s 216 <br />