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From: noreply @civicpIus.com <br />Sent: Tuesday, March 03, 2015 11:12 AM <br />To: Janice Ellis; dtaylor @paristexas.gov <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 / Committee / 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, it is the City Council's policy to appoint persons to a maximum of two <br />consecutive full three -year terms on a given body. In addition to the general qualifications listed in the certification below, other <br />qualifications may mandated by statute, City Charter, ordinance, or resolution. Please complete the information requested below. <br />First Name* Matthew Last Allen <br />Name* <br />Address` 2520 Clark Lane _. <br />City" Paris State* TX Zip* (X) 75460 O 75462 <br />Telephone <br />(903) 123 -4567* <br />Areas of Interest' <br />Please note any special knowledge, education, or <br />experience you have that is applicable to the <br />function of the board, commission, or committee of <br />interest (attach additional pages if necessary). If <br />applicable, list dates of service on any City boards, <br />commissions, or committees. <br />Certification and Authorization <br />O 75461 <br />903- 272 -7931 <br />[ ] Airport Advisory Board <br />[ ] Municipal Band Commission <br />[X] Building & Standards Commission <br />(] Paris /Lamar County Board of Health <br />[ ] Civil Service Commission <br />[ ] Planning & Zoning Commission <br />[ ] Paris Economic Development <br />L 1 Public Library Advisory Board <br />Corp <br />[) Traffic Commission <br />[ ] Historic Preservation Commission <br />(l Zoning Board of Adjustment <br />[ ] Housing Authority Board <br />[ ] Main Street Advisory Board <br />I work in the insurance field and 1 have general knowledge of housing standards. <br />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 <br />nepotism and conflicts of interest of appointees to City boards, commissions, and committees. I also certify that if appointed I will attend <br />at feast 75 percent of all regular meetings and shall not have any delinquent indebtedness to the City during my term. I understand that <br />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 <br />appointed, I agree to be placed in a database for possible future notification of topics of interest. 1 certify that the information given by <br />me in this application is true and correct and any false information or misrepresentation is sufficient grounds for disqualification. I <br />authorize the City of Paris to verify all information provided in this application. In accordance with Section 552 of the Local Government <br />Code, I understand that information provided in this application may be available to the public upon request.* <br />[X] Agree <br />' indicates required fields. <br />[ ] Disagree <br />View any uploaded files by signing in and then proceeding to the link below: <br />http:// www. paristexas .gov /Admin/FonnHistory. aspx ? SID= 127 <br />The following form was submitted via your website: Application for Boards / Committee / Commission <br />