Glasser, Ellen CARAC, CDB, CEB 8-2-07 'RECEIVED
AUG - ? 70
CITY OF ATLANTIC BEACH OFFICE OF THE CITY CLERK
BOARD / COMMITTEE MEMBER APPLICATION FORM
Please check (�) beside each Board or Committee that you are applying to serve on:
(A summary of each board/committee is available on page 2 of this form.)
ode Enforcement Boar ---- C - ommunity Development Board CZ ,)
Pension Board of Trustees Tree Conservation Board
-" Arts and Recreation Advisory Committee
APPLICANT'S NAME: /'
ADDRESS: � oc -co`n W d C..
DAYTIME PHONE: - ( Z (,2 2 EVENING PHONE: Z L ( q _ 5
E -MAIL ADDRESS: S FAX:
Please explain any employment experience, board/committee experience, and/or community volunteer
experience relative to th . board/committee applying for.
2 O 0 � ,
(/CGS I , j
a C.
,�, ,�-, ► b
( d
w a�
Please provide a brief explanation of your interest or any special qualifications you have in this field and
y ur reasons for wishing to be appointed to this board/committee.
r r . �' , i , 1 cj — c" —
C.
14 0 re Tr
r
Please return completed form to
Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
1