17-APPOINTMENT OF ONE BOARD MEMBER TO PEDC

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., ,. ,. ., ,. .,...... �r:� ry1 p�1'�:_-� BOARI?/CUMMISSION/CONfMITTEE APPLICATION The Paris City Council is seeking committed individuals �vho are dedicated to the weil-being of the Paris community to serve on its standing boards, commissions, and committees. In general, it is the City Counci)'s poticy to appoint persons to a maximum of �wo consecutive full three-year terms on a given laody. In addition to the general qualifications listed in the certification below, other qualifications may be mandated by statute, City Charter, ordinance, or resolution. PIease complete the information requested below and retum to: City Clerk, 150 SE First StreetlP.Q. Box 9037, Paris, Texas, 75461. Please note that all qualified applicants will be interviewed in open session by the City Council. BoardJCommissioti/Committee of Interest ❑ Airport Advisory Board ❑ Building & Standards Commission ❑ Civil Service Commission � Economic Development Corporation ❑ Historic Preservation Commission � Housing Autbority Board of Commissioners ❑ Main Street Advisory Board Candidate Information ❑ Municipal Band Commission ❑ Pac-�s.�Lamar County Board ofHealth ❑ Planning & Zoning Comrnission ❑ Pubiic Library Advisory Board ❑ Traffic Commission ❑ Zoaing Board of Adjustment Work Phone: i�%3• %� %�'�f` Home Phone:_/�.� %�.s �/S// Fa�c: �.3'70 j'!�-7�� E-mail Address: Iti�. c.�►4.+� p�s�e.5/d�/..w/ Please note any special knowledge, educahan, or experience yau have that is appiicable to the function of the board, commission, or committee of interest (attach additional pages if necessary). If applicable, list dates of service on any City boazds, commissions, or committtees. Certiiication and Autharization By sigung 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 conflic[s of interest of appointees to City boards, cocnmissions, and committees. 1 also certify that if appointed I witl attend at least ?5 percent of all regular meeattgs and shall not have any delinqnent indebtedness to the City dureng my term. I understand that the number of positions on a given board, comr�ussion, or committee is Iitnited and that I may not be appointed; however, if I axn aot appointed, I agree to be placed in a database for possibJe future norification of topics of interest. i certify that the information given by me in this app]icatian is true and correct and any false informallon or misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify a]I information provided in this applic ' tn accordance with Sec[ion 552 of the Loca] Government Code, T understand that information provided in this a ' atio y be a' to e pubtic upon request. Signature of Candi Date: Ror Gti#v Clerk's Use Only Conftict of Interesr Y! N Iodebtedness: Y J N Nepotism: Y/ N Dis�: 1 2 3 4 5 6 7 Previoas 5ervice: 0 1 2 3 4 5 b City of Paris Revised 03/QB/I2 �� ��