Application- Dent, Nancy CARAC 2-29-08CITY OF ATLANTIC BEACH
BOARD /COMMITTEE MEMBER APPLICATION FORM
I~.ECEIVED
Please check (~) beside each Board or Committee that you are applying to serve on: ~; ~: ~ 2 ~ ~t1t1R
(A summary of each boazd/committee is available on page 2 of this form.)
^ Code Enforcement Board
^ Pension Board of Trustees
Cultural Arts and Recreation Advisory Committee
APPLICANT'S NAME: 1 V G1 h C
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^ Community Development Boazd
^ Tree Conservation Board
^ Board Member Review Committee
~ II ^^
ADDRESS: I ~ ~ LJ ~?£' Gt ~ h i~ V ~. /-I~ ~ Oly1r{1( ~; a~`' F~. C'~,.. T ~-- ,j Z ~? S 3
DAYTIME PHONE: Zy ~ ' a a ~ ~ EVENING PHONE: "~
E-MAIL ADDRESS: "(\ . O S ~ oY>~ ~ ` ~)~r~C G! ` ~ ~. FAX:
Please explain any employment experience, boazd/committee experience, and/or community volunteer experience
relative to the boazdlcommittee 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 boazd/committee.
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Please return completed form to
Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
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