Application- Tomson, William (Bill) PBOT 2-8-12 CITY OF ATLANTIC BEACH
BOARD / COMMITTEE MEMBER APPLICATION FORM
Please check ( '1) 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
V Pension Board of Trustees Board Member Review Committee
Cultural Arts and Recreation Advisory Committee
DATE: a //0 / z APPLICANT'S NAME: Lt_ i g
ADDRESS: 377 /a TH ST 2&17 rt
DAYTIME PHONE: 70(1 K 6i EVENING PHONE: c /6` - /
E -MAIL ADDRESS: loiLU 0v,- ,Tarhson;C 601,1 4., . c
Please explain any employment experience, board /committee experience, and /or community volunteer experience
relative to the board /committee applying for.
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Pease provide a brief exp anation of your interest or any special qualifications you have in this field and your reasons
for wishing to be appointed to this board /committee.
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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.
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