Coleman, Ray CDB 10_22_07 V:y 7 2 u07 0AJVl e Ui ?Vlle Pr P h
al Y x u►r A,. LANTIC BEACH `
BOARD/ COMMITTEE MEMBER APPLICATION JFO�I
1007
Please check (q) beside each Board or Committee that you are applying to serve oil;
(A summary of each board/committee is available on page 2 of this for
7 Code Enforcement Board Community Development Board
❑ Pension Board of Trustees C Tree Conservation Board
C Cultural Arts and Recreation Advisory Committee C Board Member Review Committee
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el APPLICANT'S NAME: �aC,JIC K4,sa�,___
ADDRESS: ___
DAYTIME PHONE: qO 3-!C �5 EVENING PHONE: Z �L/ / C
E -IMAIL ADDRESS: if / " &L L 20 FAX: I t�
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to c oarstee ap ing for. a �D
4- - 1 �--� r t — 1
Please provide a brief explanation of your interest or any special qualifications you ha re in this field and your reasons
for wishing to be appointed to this board/committee
t. G �iE1 mac-
Please return completed form to
Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic' Beach, FL 32233
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