Application- Fletcher, John PBOT 1-27-12CITY OF ATLANTIC BEACH
BOARD 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 committee by order of priority
A summary of each board committee is available on page 2 of this form
Code Enforcement Board Community Development BoardPensionBoardofTrusteesBoardMemberReviewCommittee
Cultural Arts and Recreation Advisory Committee
DATE 7 7 0 Z APPLICANTS NAME At it r
ADDRESS 0 1111 1 r I 22
DAYTIME PHONE o 9 L j EVENING PHONE Wit 643 r 2Y 7
E MAIL ADDRESS 1 gu FAX 403
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Please explain any employment experience board committee experience andor community volunteer experiencerelativetotheboardcommitteeapplyingfor
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Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasonsforwishingtobeappointedtothisboardcommittee
AI 44 1 1 J L 7 J i e I III
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Please return completed form to
Donna L Bartle City Clerk 800 Seminole Road Atlantic Beach FL 32233
PLEASE NOTE This application will expire two 2 years after date of submittal
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