Howard, Mark CARAC 10-17-06
OCT-17-2006 11:36 AM FCCJ 9046462396 p, 02/02 804 247 5846 CITY OF ATLANTIC BEACH BOARDI COMMITTEE MEMBER APPLICA'nON FORM Please cbeck ("> beside each 808t'd or Committee that you arc
applying to serve on: (A summary of eadI boll'dlcomminee is available on page 2 of Ibis fonn.) a CodeEnfcm:eau:nBtoard J PensiOllBolldofTNSteca 'A. CulturalArt, andRecreationAdvisoryConunittDO
coo CommunityDevelopmentBoud Trco ConservationBoard Boud MemberReviewCommittee APPLICANT'S NAMS: .. r ADDRESS: . -0 DAY11ME PHONE:~ -2 DI Z. EVBNINOPHONE: tfl'17-197 t7 e-MAILADDRESS:
n1#DhI4'llP r; FCC"J:6PUfAX; Pleaae explain any anploynicnt experience. boudIcornmittee experience. and/or community volunteer experience: relative to the boardicomuDttee applyins for.
~ --, ~, 7 ~'r'~~ ~ 1-~ PJI1!!:r,lJ'1fn1() ~1/""~'r' ~~lv.fLs ""'I> M,-irM/~/Yi'P,.Js Pleasepro\i4. itbri"rexplanationot your interestor any lpeciBlqualificationsyoubavc ill this fielile,ndyour~
Corwishing to be appointed to thi. board/committee. ..-r PlealO retum completed form co Donna L. BU$SeY.City Clerk. 800 Seminole Road.. Atlantic Beech. FL 32233 J ---