Garrard, Cris CARAC 2-8-08
CITY OF ATLANTIC BEACH BOARD COMMITTEE MEMBER APPLICATION FORM Please check the box beside each Board or Committee that you are applying to serve on Ifyou check more than one please
rank your interest in each cboommaitrtede by order of priority Asummary of each cboommaitrtede is available on page 2 ofthis form Code Enforcement Board Community Development Board Pension
Board ofTrustees Tree Conservation Board Cultural Arts and Recreation Advisory Committee Board Member Review Committee DATE Z O ASPPLICANT NAME ADDRESS 3 tT DAYTIME PHONE 4 796C EVENING
PHONE 9C g 96 MEAIL ADDRESSicC0S1JfrIav Coen FAX 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 Donna L Bussey City Clerk 800 Seminole Road Atlantic Beach FL 32233 PLEASE NOTE This application will expire two 2 years after date ofsubmittal
Please explain any employment experience cboommaitrtede experience aonrdcommunity volunteer experience Please return completed from to