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Denene Johnson <br />•om: <br />Sent: <br />To: <br />Subject: <br />support@civicplus.com <br />Monday, September 03, 2012 12:04 PM <br />Janice Ellis; Denene Johnson <br />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 / Committee 1 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, commissions, and, committees: In general, if is the City CounciPs policy to appoint persons to a maximum of,two <br />consecufive full three-year teRns'on a given body. In addition to.the general qual�cafions listed in the cettification 6e�ouu, other <br />qualifications may be mandated by statute, City. Charte�; ordinance, or resolutfon. Please complete the information'requested' below. <br />First Name' ��� � � � � � � � `Randy �l:ast �-'Roam � � �� � � � <br />Name* ; • ` <br />Address` ;1734. Margaret $t , - . <br />City* ' Paris '�`State•' 'TX �Zip* �.(� 75460 �( ) 75462 <br />� � � � � ,� � � ' <br />� ( } 75461- " , : . . <, <br />Telephone 903-227-5280 . <br />(903) 123-4567' ; .' <br />[] Airport Advisory Board' [ j Municipal Band Commission <br />�reas of Interest` [X] Building & Standards Commission [] Parign-amar Cotinty Boacd of; <br />[X] Civil Service Commission Health . > <br />[X] : Economic Development [X] Planning & Zonirig��ommission <br />. Corporation ; I) Public, Li6rary Advisory Board <br />[] Histo�ic Preservation Commission :��� Traffic Coriimis�ion ,. ; <br />. .: ... � [ ] Zoning Board of Adjustment <br />[ l Housrng Auttiority Board of �, , <br />� � � � � � Commissioners =�_ _.. �� � � ..,, �. , . _ �� . _ � <br />�� ` � �� � � [X] StreetAdyisory. Boarcl, � � � � � � �� �� � � <br />Please note any special knowledge, education, or I; HAVE�A GREAT�REAL pF CARPENTRY �XPER�ENCE, Pl�$1.IC.�� <br />experience you`.have that is applicable-to the fiiinction �RELATIONS 8���MANU�QGTIiRI.NG �ENGWE�tING 114�iFE; �I�ETTA�&_I �� <br />of the board, commission, or committee of interest , CARE FOR 7HE"PRESENT ANO; FUTURE pARISS'1°EXAS .';. a� <br />(attach additional pages.�if.necessary). If applicable, � � _ �., <br />list dates of seNice on any City 6oards, <br />commissions, or commiitees. ' <br />Certification and Authorization � <br />y : <br />� � - ..�. 1 ¢ ,.� t . <br />.. � .. �� <g � . <br />_ ..._ n:s.. ..s b...:�t.ra�.+e� �nr1 +1,0 lauue nf tha.Sf�e tif TeXa's`�'GFf91't�InC7 <br />I acknowledge tnat i am, aN <br />nepotism and c4nflicts:of ir <br />attend at least;75 percenYc <br />understand that the numbe <br />howeveG if 1 am. not appoir <br />information given by me in, <br />disqualification: I' authorize <br />Local Govemment Code, C <br />[X] Agree <br />'` indicates required fields. <br />� proh�b�t�ons of.the <br />to Gity;boards, con <br />s' and shall not hav� <br />is <br />:rstar�d that informatiorr <br />[ j Disagree ` <br />y be availab�e,to�ins p�oua upQn reques� �M, <br />. `�1<, . . <br />