Coplan, Meade CARAC 3-11-2008
CITY OF ATLANTIC BEACH BOARD COiVIlVIITTEE MEMBER APPLICATION FORM xECEivED Please check beside each Board or Committee that you aze applying to serve on MAR 1 1 2fi0 Asummary ofeach
cboommaizttede is available on page 2 ofthis form OFFICE OF THE ctT CLERK Code Enforcement Board Community Development Board 0 Pension Board ofTrustees Tree Conservation Board Cultural
Arts and Recreation Advisory Committee Board Member Review Committee ASPPLICANT NAME 1 1 ADDRESS l O cS Q DAYTIME PHONE Zp 8 EVENING PHONE EMAIL ADDRESS a c FAX jIo gj T alva Please
explain any employment experience cboommaitrtede experience andlor community volunteer experience relative to the cboommaizttede applying for vn imis tYl 1C I n11 Al YYL Ltd l Yi II
MD 1QYVVddscep f hr1cSlfv6Qadtrlf2ic1ayotaPLeicxl4 1 i Please provide a briefexplanation ofyour interest or any special qualifications you have in this field and your reasons frowishing
to be appointed to this cboommaizttede E CJtwGCuvrw zruar1n2 nio Please return completed form to Donna LBussey City Clerk 800 Seminole Road Atlantic Beach FL 32233 1