Application- Paul, A. Brea CDB 11-2-10
CITY OF ATLANTIC BEACH BOARD COMMITTEE MEMBER APPLICATION FORM Please check Jthe box beside each Board or Committee that you are applying to serve on If you check more than one please
rank your interest in each board committee by order ofpriority A summary of each cboommaitrtede is available on page 2 of this form Code Enforcement Board Community Development Board
Pension Board of Trustees Board Member Review Committee Cultural Arts and Recreation Advisory Committee DATE 1 B ASPPLICANT NAME afC ADDRESS LQ DAYTIME PHONE CQ 3 EVENING PHONE 1c 1
EMAIL ADDRESSfQ1NVV3RAnVf FAX Please explain any employment experience cboommaitrtede experience aonrd community volunteer experience relative to the cboommaitrtede applying for r cfey
memof Ic kItc Ci t1ic Q 9 1Pt secI c kon Cpmmti cNin e t Ace ewe m non nmix t ntrGt R cam n C CA C if pc rAmiNtA a3 osmtc Please provide a brief explanation of your interest or any special
qualifications you have in this field and your reasons for wishing to be appointed to this cboommaitrtede S L 1 Ce9 PT Fr eoc lyc de rCLI Owete Please return completed form to Donna
L Bartle City Clerk 800 Seminole Road Atlantic Beach FL 32233 PLEASE NOTE This application will expire two2years after date of submittal 1