Application-Burgess, Jason CDB, BMRC & CEB
CITY OF ATLANTIC BEACH BOARD COMMITTEE MEMBER APPLICATION FORM Please check Ai 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 3 Code Enforcement Board 1 Community Development
Board Pension Board of Trustees 2 Board Member Review Committee Cultural Arts and Recreation Advisory Committee DATE 15 June 2011 ASPPLICANT NAME Jason A Burgess ADDRESS 790 Paradise
Lane Atlantic Beach Florida 32233 DAYTIME PHONE 904 521 9868 EVENING PHONE 904 521 9868 EMAIL ADDRESS iasonnaicasoonabumrgess FAX 904 981 8015 Please explain any employment experience
boardcommittee experience aonrd community volunteer experience relative to the cboommaitrtede applying for I do not have specific experience related to the committees but do have substantial
experience on other committees and boards that I have served on in the past and still currently serve on The past year I have been secretary of the Jacksonville Bankruptcy Bar Association
and have been elected to serve as the treasurer for the upcoming year In the past I have also served on the Northern District of Florida Rules Committee and was the lone creditor representative
selected I am 29 years old and have been involved in the legal community since 2004 and actively practiced law since 2007 I have routinely been one of the youngest professionals in my
field and feel that I have built up my reputation fairly quickly for being not only a hard worker but a dedicated professional I believe that my previous and current cboommaitrtede experience
will help me work with all types of personalities to do what is best for the community as a whole Also my age and experience may bring in a different view to the committees 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 I would say that my legal
background could be of particular help with the committees I am interested in the committees because I love Atlantic Beach I want the area to not only stay as beautiful and inviting
as it is today but to only get more beautiful and inviting I want to do whatever is possible to contribute to the community and hope my skills and experiences can be used to help Atlantic
Beach continue to be the desired area of Florida it is today Please return completed form to Donna L Bartle City Clerk 800 Seminole Road Atlantic Beach FL 32233 Received PLEASE NOTE
This application will expire two 2 years after date of submittal JUN 1 61 1 Office of City Clerk