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Application- Rupert, Sheena CARAC 1-9-12
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: i 1 1 II 2- APPLICANT'S NAME: 5 i--I e EN A G• lZu P =T -T ADDRESS: 3aL( - 1 -- t - 4 s rtz�.6. T , K L 4\Ttc_. t �\C4 -4 DAYTIME PHONE: 11 - ©(43.d i (H) EVENING PHONE: 6 - 3 S 1 Cc- E -MAIL ADDRESS: in S ru f e FAX: Co v\C n Please explain any employment experience, board /committee experience, and /or community volunteer experience relative to the board /co mittee a for. \fC to v *e - * e_ Law fi il, 1 ( s 1, v)e .Eu v (c {r.s t , u - &iv bu vow. u A,Lt9 tc�,i,n C�,�nc r -50 c.�-e List( uiZocr 3,ex vr, d v e ovvvs-pcY -i7,6 rn v ct,v\cl pubtt C o nAN\L s . t was ca So cuv` a (- Pe.. Nne vu,b.e. Of-Lkt Q- Pt coi.0 l eY C l u h c Do ucp‘ S Ae -r,scm & kwl 6-r 4 A &w cX 6 7- QO [ 0 . 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. IkS A - C - aA ikk, V\-e vA ki avOlc, ou-k■ Ne i t96r tiles' (va,Jv'e.. 4'1x52_ C om inn u u ' £ &e& k s culkol O (1kc i p rrcvvS . 1 kcu Ue- d �- .-4-1 w�- c�u tL Q-e c u.) 0 u Lc( .� ke-L , 1 i,(5 c _, 9 ,V C12 s5 (AI C1„0 . 1 a..l,s o kaA e.. 01 1 cSVQ__ Oc u;Y +5 w wad al r vve fie- 0 pav 62_ VvA W VO L VQc (AA, 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