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Application - David L. Jeffery, CDBCITY OF ATLANTIC BEACH BOARD /COMMITTEE MEMBER APPLICATION FORM Please check (~) beside each Board or Committee that you are applying to serve on: (A summary of each board/committee is available on page 2 of this form.) ^ Code Enforcement Board C~Community Development Board ^ Pension Board of Trustees ^ Tree Conservation Board ^ Cultural Arts and Recreation Advisory Committee APPLICANT'S NAME: ~/~ ~~~ L. 1/~l-l`~12Y' ADDRESS: 1~~~ ~.J~~~~~ml~-c--~U~,/J ~% L ,(~Cff ~Z-Z-~3 DAYTIME PHONE: Z ~~ ,~~~ ,~ EVENING PHONE: ~- E-MAIL ADDRESS: ~~ ~ ,~ ~ ~.~~: _ Fes; - Please explain any employment experience, board committee experience, and/or community volunteer experience relative to the board/committee applying for. fib % /~ /Cr~/°T _. Phase 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. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 /~Sl ~ ~ ~S ~[:/.c~T/ Y~ Tv /h2- ~~~'~bs' ©/= //l~ 4l~~bl~,~~ ~i/~ f~C9R CI rte/