Parkes, Harleston CDB 11-12-07 CITY OF ATLANTIC BEACH
BOARD / COMMITTEE MEMBER APPLICATION F(MIVED
Please cock (ti) beside each Board or Committee that you are applying to serve on: NOV 1 2 2007
(A summary of each board /committee is available on page 2 of this form.)
\ OFFICE OF THE CITY CLM
❑ Code Enforcement Board V Community Development Board
❑ Pension Board of Trustees ❑ Tree Conservation Board
❑ Cultural Arts and Recreation Advisory Committee ❑ Board Member Review Committee
APPLICANT'S NAME:
ADDRESS:
DAYTIME PHONE: EVENING PHONE: 7S�AAg-
E -MAIL ADDRESS: Cc��J1L
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 any special qualification-. you have in this field and your reasons
for wishing to be appointed to this board/committee.
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C-0 G'10 W l L I-N — VOEI - �
Please return completed form to
Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
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