17-APPOINTMENT OF ONE BOARD MEMBER TO PEDC

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S';r"' :: 6; � i! � ks a. ,== F , BOARD/COMIVIISSION/CONIlVIITTEE APPLICATION The Paris City Council is seeking committed individuals who are dedicated to the well-being of the Paris community to serve on its standin.g boards, commissians, and cornmittees. In general, it is the City Council's policy to appoint persons to a maxi.mum of two consecutive full three-year terms on a given body. In addition to the general qualifications listed in the certification below, other qualifications may be mandated by statute, City Charter, ordi.nance, or resolution. Please complete the information requested below and retum ta: City Clerk, 15Q SE First Street/P.O. Box 9Q37, Paris, Texas, 754b1. Please note that all qualified applicants will be interviewed in open session by the City Cauncil. Board/Commission/Committee of Interest ❑ Airport Advisory Board ❑ Municipal Band Commission ❑ Building & Standards Commission ❑ ParislLamar County Boazd of Health ❑ Civil Service Commissian ❑ Planning & Zoning Commission � Economic Development Corporation ❑ Public Library Advisory Boazd ❑ Historic Preservation Commission ❑ Traffic Commission ❑ Housing Authority Board of Commissioners ❑ Zoning Board of Adjushnent ❑ Main Street Advisory Boazd Candidate Information Name: Y 1 C 1` �.5 5 1 I�' Address: 75 work Phone: 903 - 7 SS -� y a�1 ]E�e�e'Phone: �'0 3- 5 I rI - �?� n 1 Fax: 9 03- 7��- 7 �� 5 E-mail Address: V r e, T'e s s I e r@ C en -� cc ru � I. C � r'� Please note any special knowle�ge, education, or experience you have that is applicable to the function of the boazd, commission, or committee of interest (attach additional pages if neeessary). If applicable, list dates of service on anv Citv boards, commissions, or comrnittees. �11� :%C� �orioc.at Qro��-��, and requ.larlu c�ndu.c� e,ivie�-ours�°r �r�oe.��F►��. r�e.w bu�inQs� Certification and Authorization� �'�� u� e 5� a-� ar �- �5 �,�-r 9 g t�0.�� S�«a •� ti Ra nc.e �at�nh.�►�-e¢. e.htl�r �br o� a� e. u.rc.h. By signing below, I aclrnowledge tbat I am aware and agree to the prohibidons of the City of Paris Charter and the Iaws of the State of Texas regazding nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also certify that if appointed I will attend at leFtst 75 percent of all regular meetings and shall not have any delinquent indebtedness to the City during my term. I understand that the number of positions on a given board, commission, 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 af interest I certify that the information given by me in this application is true aztd correct and any false information or misrepresentarion is sufficient grounds for . disqnalification. I authorize the City of Paris to verify all information provided in this application. In acco ance with Section 552 of the Local Government Code, I understand tbat informarion provided in this applica ' may b v able to the public upon request. Signature of Candidate: �� Date: 3/��/� City ofParis Revised 03/08/12 - !�