AgendaItem2H-BMRC-7-28-05 Lambertson, Chris v AGENDA ITEM#8B
JULY 26,2004
CITY OF ATLANTIC BEACH
BOARD/COMMITTEE MEMBER INFORMATION SHEET
NAME OF BOARD/COMMITTEE PI Aiv
NAME OF APPLICANT/MEMBER £ 2l t4'' b� -T30A-
ADDRESS f?7 ]4 51Xerl— Afes.,441L Get FL . 3z23 5
DAYTIME PHONE 341.- 2*, EVENING PHONE 391-5-2-Cr
E-MAIL ADDRESS N14- FAX# 2111-or yC
Please provide a bre`explanation of your interest or any special qualifications you have in this field and your reasons for
wishing to be appointed to this board/committee.
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Please return completed form to
Maureen King, City Clerk. 800 Seminole Road. Atlantic Beach, FL 32233
RECEIVED Fax 247-5846
APR - 2 2004
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