Item 5A-5B BMRC RecommendationCall to order
MINUTES
Board Member Review Committee Meeting
March 18,2015
5:00p.m.
AGENDA ITEM# 5A/5B
APRIL 13, 2015
The meeting was called to order at 5:00 p.m. by Commissioner Jimmy Hill. In attendance were
Commissioner Jimmy Hill (Chairman), Members Jeny Johnson, Solomon Brotman and Rita Pierce,
Police Officers' Pension Board of Trustees Chair John Wolfel, Cultural Arts and Recreation Advisory
Committee Chair Grant Healy and City Clerk Donna Bmtle.
1. Approval ofthe minutes of the BMRC meeting of March 4, 2015.
Motion: Approve minutes of the Board Member Review Committee meeting of March 4, 2015.
Moved by Brotman, seconded by Johnson
Motion carried unanimously
2. Make a recommendation on filling one vacancy on the Community Development Board for
term ending 12/31/2016.
The Committee began discussions on this and decided to continue their discussion on the topic later in
the meeting.
3. Interview the new candidates (listed below) for consideration to the Board/Committee(s)
indicated.
A.
B.
Judy Hoedel-Workman
Robert Liggero
(for PBOT & CARAC)
(for PBOT)
An overview of the duties and responsibilities of the Pension Board of Trustees' was explained to Ms.
Workman and Mr. Liggero, and an overview of the Cultural Arts and Recreation Advisory Committee
was explained to Ms. Workman. Each candidate explained their personal accomplishments,
experience, goals and interests in the community. The Committee offered the opportunity to ask
questions and the Committee responded to those questions.
4. Discuss the applicants above and make a recommendation on filling the unexpired term ending
6/10/2017 on the Police Officers' Pension Board of Trustees.
The Committee discussed the two candidates.
Motion: Recommend aooointing Robert Liggero to fill the unexpired term on the Police
Officers' Pension Board of Trustees ending June 10,2017.
Amendment to the motion: If Mr. Liggero cannot serve for any reason, then Ms. Workman will
be asked to serve.
Moved by Brotman, seconded by Hill
Motion carried unanimously
5. Interview the new candidate (listed below) for consideration to the Cultural Arts and
Recreation Advisory Committee.
A. Charlise Goodbread (for CARAC)
AGENDA ITEM # SA/SB
APRIL 13, 2015
The Committee interviewed Ms. Goodbread. An overview of the duties and responsibilities of the
Cultural A1is and Recreation Advisory Committees were explained to Ms. Goodbread amd she
explained her personal accomplishments, experience, goals and interests in the community. The
Committee offered the opportunity to ask questions and the Committee responded to those questions.
6. Discuss candidates interested in serving, but who were unable to attend the interview:
A.
B.
Jay Wilson
Nick Malie
(forCARAC)
(for CARAC)
Ms. Bmile rep01ied that William (Bill) Baldwin is also interested in being considered, so she
distributed his application to the Committee for consideration.
The Committee discussed all five applicants.
7. Make recommendations on filling the following vacancies on the Cultural Arts and
Recreation Advisory Committee:
1-Cunent vacancy with term ending 7/8/2016
1 -Cmrent vacancy with term ending 7/8/2015; then reappoint for additional2-year term
2-Upcoming vacancies on 7/8/2015
During further discussion of the five candidates, the Committee made the following recommendations.
Motion: Recommend appointing Charlise Goodbread to immediately fill the unexpired term on
the Cultural Arts and Recreation Advisory Committee and then reappointing her to an
additional term ending July 8, 2017.
Moved by Brotman, Seconded by Hill
The motion passed unanimously.
Motion: Recommend appointing Jay Wilson to fill the unexpired term on the Cultural Arts and
Recreation Advisory Committee beginning immediately and ending July 8, 2016.
Moved by Brotman, Seconded by Healy
The motion passed unanimously.
Motion: Recommend reappointing Nick Malie to the Cultural Arts and Recreational Advisory
Committee to serve an additional term ending July 8, 2017.
Moved by Healy, Seconded by Hill
The motion passed unanimously.
Motion: Recommend appointing Judy Hoedel-Workman to serve on the Cultural Arts and
Recreational Advisory Committee for a two-year term beginning July 9, 2015 and ending July 8,
2017.
Moved by Brotman, Seconded by Healy
The motion passed unanimously.
Draft-Minutes of the Board Member Review Committee Meeting on March 18, 2015. Page 2 of3
Motion: Recommend Mr. Baldwin as an alternate choice to fill any future openings on the
Cultural Arts and Recreational Advisory Committee that may come available on or before
August 28, 2015.
Moved by Hill, Seconded by Johnson
The motion passed unanimously.
2. Make a recommendation on filling one vacancy on the Community Development Board for
term ending 12/31/2016.
The Committee resumed discussion on this item.
Motion: Recommend reappointing Harleston Parkes to serve an additional term on the
Community Development Board ending December 31, 2016.
Moved by Brotman, Seconded by Johnson
The motion passed unanimously.
Commissioner Hill repmied that he has asked the Commission to address changing the number of
Community Development Board members from seven to nine and explained his reasons. Discussion
ensued.
Citizen Clu·is Jorgensen was in the audience and was invited to comment. He stated he believed this
board is important and that in some cases citizens apply for a board without really knowing what that
particular board does.
Adjournment
There being no other business, the meeting adjourned at 6:53p.m.
Jimmy Hill
Chai1man
Draft-Minutes of the Board Member Review Committee Meeting on March 18, 2015. Page 3 of3
CITY OF ATLANTIC BEACH
BOARD/COMMITTEE MEMBER APPLICATION FORM
AGENDA ITEM# SA
APRIL 13, 2015
Please check (.Y) 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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
Code Enforcement Board
Pension Board of Trustees
Cultural Atis and Recreation Advisory Committee
~ Community Development Board D Board Member Review Committee
APPLICANT'S NAME: ~-r _o----"b~e_.--_+-__ L----'~i..J-, fl-~-..e_r_0 _____ _
{ J-t-~ -S' t-A~ \1{.-t t 1'<-1) c ~ F-( 3Jt-] 3
DATE: ~ ~ ~~
--=-l-----L---
ADDRESS: 3 3Cf
DAYTIME PHONE: 9 0 t.-( d L-/t -<f ' ~ '-(
E-MAIL ADDRESS: ~L·IJ e@AOL.. ~
EVENING PHONE: qo L-( ;:2 Lft Y bJL(
FAX: _____,_q_o l( _ _;:__~____,_f---=-)__CO __ b_7_
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for.
AkfA+ (.,."" ( ;~__
s+.
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 board/committee.
I ( r " ·
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict oflnterest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
1
AGENDA ITEM # SA/SB
APRIL 13, 2015
CITY OF ATLANTIC BEACH Received
BOARD/COMMITTEE MEMBER APPLICATION FORM
OEC 2 2 2014
Please check (.,J) 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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.) Office of City Clerk
Code Enforcement Board
Pension Board of Trustees
Cultural Arts and Recreation Advisory Committee
DATE: (7f"D£C
1 ttf APPLICANT'S NAME:
ADDRESS:
DAYTIME PHONE: (CJo</) <i? 5"3 -L 777
I
I s Community Development Board
Board Member Review Committee
EVENING PHONE: __ ____,.,:)=-J.VI'I____,'C---__
E-MAIL ADDRESS: Jhwot:lt.v-tM@?L(d./tao 1 FAX: __________ _
-.J Cc:f\1
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for.
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 board/committee.
J_-ckS-/rt-e. -lu b~ ,v\JuiJ~ ,~ Mi l~ca.l (i~Jt1U~i·+cr,
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
CITY OF ATLANTIC BEACH
BOARD I COMMITTEE MEMBER APPLICATION FORM
AGENDA ITEM# SB
APRIL 13, 2015
Please check (..J) 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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
Code Enforcement Board
Community Development Board
Pension Board of Trustees
Board Member Review Committee
_x_Cultural Arts and Recreation Advisory Committee x General Volunteer
DATE: 11/6/2014 APPLICANT'S NAME: Charlise Goodbread
ADDRESS: 440 Osprey Key, Atlantic Beach, FL 32233
DAYTIME PHONE: 386-316-5767 EVENING PHONE:
E-MAIL ADDRESS: cgoodbread@bellsouth.net FAJC: __________________________ _
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for.
I'm a new homeowner in Atlantic Beach, FL and want to contribute to the success of the community. I have more
than 10 years of proven experience marketing and executing successful programs and working with teams.
Currently, I'm responsible for branding, marketing and new program development for the BASF Corporation
focusing on expanding BASF's presence in the North American residential and commercial construction markets.
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 board/committee.
I have strong leadership skills and a proven ability to manage and motivate a team. I feel that my management and
leadership experience will have strong contribution to the volunteer programs.
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
'trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
1
CITY OF ATLANTIC BEACH
BOARD I COMMITTEE MEMBER APPLICATION FORM
AGENDA ITEM# SB
APRIL 13, 2015
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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
Code Enforcement Board
/ Pension Board ofTrustee{J>
~ Cultural Arts and Recreation Advisory Committee 0
/ Community Development Board G ~
v' Board Member Review Committee0)
DATE: 9 /5~f{
' I
APPLICANT'S NAME:
ADDRESS:
DAYTIME PHONE: ___,lp""-0-0.-l{-'---=.~-=-=----\-. =-3 .:;__?.-'--)..._\ __ EVENING PHONE: _______ _
E-MAIL ADDRESS:
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for.
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 board/committee.
~~~~~~~~~~~~~~~~~~~~~~~~~
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
of'lv5 ~ ..
~c.~~ ~~J.
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
EDUCATION
James "Jay' Wilson Ill
1842 Hickory lane, Atlantic Beach, FL 32233
804.221.3211
jayrbwilson@gmail.com
University of South Carolina, Columbia , SC
Bachelor of Administration in Psychology, May 2004
Member of Psi Chi, the International Honor Society in Psychology
Assisted in two published Medical journals {Molecular Psychobiology and Sports Psychology)
Student-Athlete Men's Soccer
Earned Dean's list designation
GPA: 3.3
PROFESSIONAL EXPERIENCE
Stryker Craniomaxillofacial, Jacksonville, FL, 2012-2014
Sales Representative
AGENDA ITEM# 5B
APRIL 13, 2015
• Plan, direct and coordinate the selling of product portfolio to achieve corporate objectives and maximize volume and
profitability.
• Consulted with Marketing on playbooks, and marketing material newly launched products
• Perform field calls to variety of health care professionals, including on-call and operating room consultation for surgical
specialists.
• Lead the effort to change mindset of surgeons and hospital administration, while fostering and strengthening key industry
relationships.
• Implement new sales plans and effective marketing strategies to position the organization competitively and exceed
territory objectives.
• Create and execute new record keeping system to track sales, history, and market trends to increase efficiency.
• Used lessons learned from Karrass Negotiation Course to secure sole source agreements which helped achieve 30% growth
in 2013
Stryker Craniomaxillofacial, Richmond, VA 2010-2012
Associate Sales Representative
• Developed crucial relationships with decision makers in hospital administration and health care systems.
• Created and executed sales and action plans for sales growth strategy.
• Developed business plan for the surgical instrument and implant markets that ensured attainment of growth objectives.
• Achieved 30% sales growth in first year within assigned territory.
• Awarded MVP of Phase 3 training class in April, 2011
• Awarded Sales Rep of the Month
• Awarded Team Player award
• Finished at 111.8% PTQ 2011, and at 101.8% PTQ 2010
Driven Marketing, Dallas, TX 2007-2010
Director of Sales
• Developed a co-promotional marketing platform that allowed discounts for events, products and services to participating
organizations and companies.
• Selected to develop and provide presentations relevant to the return on investment inherent to utilization of the products
and services offered by the J. Reider Group
• Recognized, for increasing sales from $0 to generating over $1.7 million in revenue for fiscal years2007-2009 during tenure
as the Marketing and Sales Director for Driven Marketing in the Dallas Market.
• Managed a team of 121nside Marketing/Sales reps
• Managed a team of 50+ Outside Sales reps
FOREIGN LANGUAGES
Portuguese-beginner level
THE THONBURI HOSPITAL PUBLIC CO .. LTD
www.thonburihospital.com
To whom it may Concern,
AGENDA ITEM# 5B
APRIL 13,2015
J4·! IS~;'jri1J~l3p Road &~ •14, Ban;.~tlk'lo'. 8.-'lr'(j~ok IOTC'i)
Tel. 07·866·1333. 02·412·0020 Fax. 02-412·7343
My name is James Nanakompanom and I have had the privilege to work and play soccer with Jay Wilson for
severn! years.
We met for the first time playing for the Arizona Heat semi-professional indoor soccer team, which
flourished into a great friendship in which I learned how loyal a friend and teammate he is. As all athletes
experience the ups and downs of playing any sport at a high level we all need a supportive teammate, just as
in life, a good friend is like finding a diamond in the ruff, and that is how I describe Jay Wilson's character
and loyalty to anything he becomes a part of in work or leisure.
I also had the chance to work with Jay in a cold call, door to door sales job in Phoenix, Arizona
What you have to think about is what separates great salesman from barely getting by salesman, extraordinary
from ordinary salesman. Not all people have it, but Jay does: The abilily to connect and inspire people on a
different/eve/, this includes but not limited to: great charisma, great communication. makin& people laugh.
and being sincere. These qualities are what I saw instilled in everything that makes Jay who he is, coupled
with his southern drawl, character, and loyalty was an example for me everyday as we entered the cold office
every morning at 6am to get ready for the sales day.
Another important trait that I noticed and learned from Jay is what all sales people need:
Determination, the ability to not be let down by a NO, because as all people on both sides as getting a sale
pitched to them or selling a pitch to a customer, NO is the answer that always comes first Jay's detennination
combined with his ability to connect with people made him a sales leader just a weelc after we started, a
manager just short after. Jt was a special thing watch Jay talk to customers and motivate us every morning to
do a job, door to door sales, in which as everyone knows is a pretty difficult job to do, it's not for everyone
but Jay flourished.
You can be great with people and be detennined which are great traits but there are two roads to
choose from: I. A Selfish way and just work for yourself and malting money off of people and not care about
your team, or 2. Concentrating your abilities to be a great leader, team member, and to help people become
great as well, and that is what I learned ftom Jay as I worked with him and played soccer with him. In
everything Jay did, he took the helm of a leader and developed people as well as shown an example of what
great leaders should be like.
Jay Wilson with be a great asset not only managing the sales team and a loyal co-worker but also if
you Jet him, he will be the pulse to help grow the starting soccer franchise into a great money making
machine.
Sincerely,
James Nanakompanom
International Business Development D'
Cell: ... 66 (0) 851395142 Email: jnanakom@gmail.com
05/06/2014 10:25 FAX
Morgan Stanley
May 5, 2014
To whom it may concern,
AGENDA ITEM# SB
APRIL 13, 2015
Wealth Management
One Blue Hill Plan
Suite 100
Pe2rl River, NY 10965
tel 845 731 2500
fax 845 731 2550
toll free 888 848 5067
It is my pleasure to be writing this letter recommending Jay Wilson. I had the
opportunity to work with James for approximately two years. During this time I was able
build a relationship with him professiot;~ally and personally. Please accept this letter to
learn the reputation of the qualities he has.
First of all I would like to describe his dedication. Whether it is from bringing a
sense of urgency to every work task he has, to making sure all ofhis personal matters are
in order, he attru?ks every day to truly exemplify the expression "Seize the day". He takes
personal pride in himself Therefore, any task no matter how small or large he would go
above and beyond and never Settle WJ' tbe b~e-ffiimmum-. ai$ work-would almost leave
a signature.
The next thing that remarkable was his teamwork. Jay's humble nature and
approachability allowed for him to spread him self out to his teammates. He could work
with anyone and make them feel comfortable to ask tough questions that they could work
through together. While giving of his time he never seemed to ever take a step back in
his own personal work. He always believed that the best way to improve-his situation
was to help improve the ones around him first.
Finally I want to address his leadership. He always believed in leading from
amongst and never from above. He would never ask or expect anyone to perform a task
if he had not done and understood it already. Therefore, he had a way to motivate others
to expect the best out of themselves because they saw him generate the best of himself I
was abfe to watch. Jay cultivate some of the 1argest and most productive teams in the
nation. His team still holds records in many of the most important categories within the
company. I assure you that this wasn't a coincidence, but a pattern of coaching and
developing talent.
Jay was instrumental for my development. Few people I have worked with have
left as much of~ impact. I str()ngly recommend Jay for any position, opportunity or
endeavor that he pursues. He will be valuable to any organiZation.
Sincerely,
~hdV:
Joseph Brunelli
Financial Advisor
Morgan Stanley
914 589 9960
Morgan Stanley Smith Barnoy LLC. Member SIPC.
MICROFIXATION
To Whom It May Concern:
AGENDA ITEM# 5B
APRIL 13, 2015
Please accept this as my personal letter of recommendation for Jay Wilson. As a Sales Representative
for Biomet Microfixatlon and former sale rep for Stryker, I have seen firsthand Jay's exceptional sales
skills, managerial skills, and how he immediately became an integral member of the company. Now, a
few years later, he Is in pursuit of new opportunities to expand on his considerable skills. I have
personally tried courting and recruiting him for my current company based in Jacksonville, FL.
Jay has a winning attitude that embraces all challenges and encourages collaboration. The phrase "team
player" is often overused, but Jay is truly that. He draws the best out of every person, promotes talent
and has succeeded at every task handed to him. To better my services, I use many of Jay's ideas and
practices. These ideas and practices are now being mirrored by many other regional managers and sales
representatives.
Jay is also an effective leader. He clearly communicates expectations and notes strengths to better
improve his team's performance. Out of the multiple sales reps I have known over the years, Jay was is
the only one that continues to show high amounts of profit and with high marks every year.
It is my pleasure to recommend Jay Wilson for any position or endeavor that he may seek to pursue. He
will be a valuable asset for any organization.
Sincerely,
Michael Balger
Sales Representative
GO·. 8{p({. 5 514t
1520 TradepOtt Dnva
Jacksonville, FL 32218-2480
Office: 904 741.4400
Fox: 904.741.4500
VMW.blom&tmiclofixaliln.com
LORENZ PLATING SYSTEMS I LACTOSORB I STERNALOCK I PECTUS BAR I MIMIX I TMJ I DISTRACTION I HTR I LORENZ SURGICAL INSTRUMENTS
I<C+I KINGSTON
GENERAL
HOSPITAL
To Whom It May Concern:
}1, Sl!Jf,I<T S;IH'ET
K:NGSlON ONT.t>,rW)
K 7L 2V 7
TE~ 6i3-548<l217
AGENDA ITEM # SB
APRIL 13,2015
Please accept this letter as my personal letter of recommendation for James Wilson. 1 haw
known Jay for over 10 years and he has played an integral part in my personal lite nnd
professional life. We ha\'e worked together. as well as been teammates on a varsity soccer team
at a high collegiate leveL
Now that he is in pursuit of new opportunities to expand his abilities, 1 have no doubts that he
w·ill be an asset to your organization. Jay is an accomplished and self motivated individual who
never seems to be content \Vith just being average. Through his easy going and open minded
nature. he is always looking at personal and profession improvement.
Jay has a winning attitude that embraces all challenges as an opportunity to succeed. His hard
working and positive attitude is contagious, which always encourages collabmation. The phrase
''team player" is often over used. but Jay is truly that. He draws the best out of people, pmmotes
talent and shares his and their successes.
I've known him to go above and beyond. and have aJv;ays seen him reach his goals. even if not
successful in his first attempts. Jay is incredibly intelligent and an amazing leader. He seems to
learn from his mistakes and loves to share his experience and knowledge with others
[tis with great pleasure that 1 write to you in recommendation of James Wilson. As a honest and
caring individual with strong moral values 1 am certain he will make an extremely valuable asset
to your organization.
lfyou have any questions. please do not hesitate to contact me.
Sin~cerely. J}' . ,........--· .• .,.,.·-·;;.. .. "
/ .? ..C-4-~ . .. .
,.,. • ...-· ~-:~ ,• . ' .,.:._ __ ~ ... _.~··· .. ~-_...r'
_,,~~~~~--
Felipe Pereira B.Sc., M.D.
F.R.C.S.C. Candidate
Orthopaedic Surgery Resident
Queen's University
938 Swanfidd Street
Kingston, ON. K7M OAS.
Email: felipe.pereira@queensu.ca
'feJ: 613.449.4433
Fax: 613.544.917
An Acc;edl1ecJ reaching Hospiiol qffi!iutc~ci with Quw~n·s :.;r,iversitv se1vin(J Soutt1eostern l.)ntorlo tor morn them l.SC1 yw-11!;
CITY OF ATLANTIC BEACH
BOARD I COMMITTEE MEMBER APPLICATION FORM
AGENDA ITEM# SB
APRIL 13,2015
Please check (--J} 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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
~Code Enforcement Board 1 Pension Board of Trustees
~ Cultural Arts and Recreation Advisory Committee
DATE: ?!/~~~
( ('
APPLICANT'S NAME:
ADDRESS: ::) 2/ 5'" /j,v'i"/; 121:=s
DAYTIME PHONE: ___,CJ_""-'---'-Jj---'Cf_' --=-tf-=· 3:__f-::___L. __ _
Community Development Board
Board Member Review Committee
ftTL/I.vTJ~ )3.f"lttJ-/-l:;2 SZ233
. I
EVENING PHONE: ;). zf Cf-fi 3;.. 2-
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for. ~ , . 1 :-:::::> w t/~S L.796Crt.. /<?.GL/?//O.V5 ~ H«/114/\/ 025dt-t~5
'
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 board/committee.
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
1
AGENDA ITEM # SB
APRIL 13, 2015
CITY OF ATLANTIC BEACH
BOARD I COMMITTEE MEMBER APPLICATION FORM
Please check (---1) 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 I committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
Code Enforcement Board
Pension Board of Trustees
Cultural Arts and Recreation Advisory Committee
DATES) ) ~ )~ APPLICA~T'S NAME:
ADDRES: .. ) J33 ~p_V \. ) \ £1
DAYTIME PHONE:9~ j GS.s; [;0)6
E-MAIL ADDRESs f-lo )I t-r Q) CCI Me mA
~
Community Development Board
Board Member Review Committee
w·, ~j ioA CJ5\\j)fJ?f!IJJVV )N
B)vd .. \NQ~± fi . ..£>, 3~J
EVEN:a PHONE:&)!)~ ~:\'J~()S'f
FAX: _________ ~~-----------------
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applyi g £ r.
(M') C£0
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 board/committee.
PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of
Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"
is provided on page two of this application. This application will expire two (2) years after date of submittal.
1