Application- Tomson, William PBOT 2-8-2012CITY 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 boardcommittee is available on page 2 of this form
Code Enforcement Board Community Development Board
V Pension Board of Trustees Board Member Review Committee
Cultural Arts and Recreation Advisory Committee
DATE a 0 z APPLICANTS NAME Lt i g
ADDRESS 377 a TH ST 217 rt
DAYTIME PHONE 701 K 6i EVENING PHONE c6
E MAIL ADDRESS loiLU 0vTarhsonC 6011 4 c
Please explain any employment experience board committee experience andor community volunteer experience
relative to the board committee applying for
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aowlo 174c S 12 2Peaseprovideabriefexpanationofyour interest or any special qualifications you have in this field and your reasons
for wishing to be appointed to this boardcommittee
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o Po r rtrti7y To ti 1 X h 217 Pro A vD Jam S iZ
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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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