Gaglione, Lori CARAC 1-30-07
--. ----CITY OF ATLANTIC BEACH BOARD /COlVIMITTEE MElVIBER APPLICATION FOiMElVED Please check tV) 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 fonn.) JAN3 n2007 Code Enforcement Board Pension Board of Trustees Cultural Arts and Recreation Advisory Committee oo o OFFICEOFTHECITYCLERK
Community Development Board Tree Conservation Board Board Member Review Committee DAYTIME PHONE: I E-MAIL ADDRESS: Lon'G1 ~~ 50 EVENING PHONE: -',104-/;;)If' . '0 B2>~ FAX: 1Dtl dlft1.
~~ 3 APPLICANT'S NAME: ADDRESS: Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for.
Please provide a brief explanation of your interest or uny..special qualifications you have in this field and your reasons for wishing to be appointed to this board/committee. I, 1/'
i~ l) I v Please return completed form to f'~CR-S ~V\ Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 I