Johnson, Jolyn CDB & TCB & CARAC
CITY OF ATLANTIC BEACH BOARD I COMMITTEE MEMBER APPLICATION FO~ECEIVED NOV1 4 2005 Please check (...J) 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.) 0 Code Enforcement Board ~ommunity Development Board 0 Pension Board of Trustees ~Tree Conservation Board p/' Cultural Arts
and Recreation Advisory Committee OFFICEOFTHECITYCLERK -~I APPLICANT'S NAME: .::.jG LYH .j 0 H~ 501') ADDRESS: 2 '3 2."Z.-b~c.hco VV\'De V' ""'\\['~. \\ DAYTIME PHONE: ~ EVENING PHONE:
24q-{"-~ FAX: ~ o~I~ Please return completed fonn to Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 I
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