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Application- Marshall, Martha CARAC 5-28-14
CITY OF ATLANTIC BEACH BOARD / COMMITTEE MEMBER APPLICATION FORM Please check 6) 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 Board Pension Board of Trustees — Board Member Review Committee Cultural Arts and Recreation Advisory Committee DATE: 5/a©/i`7" APPLICANT'S NAME: /"1/Qk`4l 4 g//4 f5h 04-I/ ADDRESS: /62&3 3e. Dais 12 • — -- DAYTIME PHONE: 9-b'I 5/7 7/32. EVENING PHONE: 9a 5/7 !/3 2 E-MAIL ADDRESS: /241 & &'3#e)gr/5$1-0(FAX: 0 --- Please explain any employment experience, board/committee experience, and/or community volunteer experience relati to the board/comm e apply n 1 /� a4 �t , �C ,,/i4d/A/ ZJ i✓ ac / !rw 1,-, _ /ILA -e-e-,- ((- Z.�/—��-—t# ►L/� // �f` •- NZ- hi a j- �4;- G )� 4�z�'�-tee , , , ---_- ck14/'( .' Z.� . X7-7-- , 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 board/committee. .. /kW ' / p , ' /.." At- 5407 &mit( a 4i-e,c 6-c-,-- Z.G, , ,/yG. ) eatou t -ae x-e.!F-, _9Z-I, 7 ` _ ,6 eeto e. Cat _Vetz-e . it.-6e/ 1,e/64.t. k; ---- .. - - __,.. -x=a...-e .,...,e- 9,e,„.ae.t ..,<_24 . (p2eas Lia_z76.2 . , L ,,.:2,/,‘ew bz e4-itt../ee Please return completed form to Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 PLEASE NOTE: Members of the Code Enforcement Board, Community Development Board and Pension Board of Trustees are required to file Statement of Financial Interest Forms. Also, information regarding "Conflict of Interest"" is provided on page two of this application. This application will expire two (2) years after date of submittal. 1