Application-Corey, Cindy CARAC 6-3-11
CITY OF ATLANTIC BEACH BOARD COMMITTEE MEMBER APPLICATION FORM Please check the box beside each Board or Committee that you are applying to serve on If you check more than one please
rank your interest in each board committee by order of priority A summary of each boardcommittee is available on page 2 of this form Code Enforcement Board 1 Community Development Board
Pension Board of Trustees Board Member Review Committee Cultural Arts and Recreation Advisory Committee DATE x 2l ASPPLICANT NAME 4ft ADDRESS 3g Pe ST 6 z 1Zrf7riCl DAYTIME PHONE 9 X73
7 EVENING PHONE EMAIL ADDRESS e y Cee 7e FAX i 771i711 Please explain any employment experience boardcommittee experience andor community volunteer experience relative to the boardcommittee
applying for 1 it i f 7 St Jrs0 1 1 Ati s 7 r 1 4te 1 11 Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons for
wishing to be appointed to this boardcommittee ii 1 rt d C i JJJ Al 1 f iI 4 i tea L I Lt Please return completed form to Received Donna L Bartle City Clerk 800 Seminole Road Atlantic
Beach FL 32233JUN 3 2011 PLEASE NOTE This application will expire two 2 years after date of submittal 1 Office of city ckie