Application - Eilers, Elizabeth T. (All)CITY OF ATLANTIC BEACH Received
BOARD / CONIlYII.'TTEE MEMBER APPLICATION FORM
JAN 1 5 ~O9
Please check (~) the box beside each Board or Committee that you are applying to serve on. If you check more than
orie, please rank your interest in each board /committee by order of priority.
(A summary ofeach baazd/committee is available on page 2 of this form.) OMia dClty c~
_~ Code Enforcement Board
/ Pension Board of Trustees
Cultural Arts and Recreation Advisory Committee
1~ Community Development Board.
~_ Tree Conservation Board
Board Member Review Committee
DATE: ~ -.~' /~ -- ~ ~, APPLICANT'S NAME: ~~/zi9- f3 g 7` ,~- f % ~ ~ / G. ~ ,e S
ADDRESS: 3 ~o ~ j/y~h~y ~ r ~l /_~ ~~ 3Y~- 3
DAYTIME PHONE: ~o ~ - .~ ~{ ~ -c~" 3o y EVENING PHONE:
E-MAIL ADDRESS:
FAX:
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the boazd/committee applyin for. ~~ ~~ /j ~/
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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.
1
Please provide a brief explanation of your interest or any special qualifications you. Dave in this field and your reasons
for wishing to be appointed to this boazd/committee.