HomeMy WebLinkAboutItem VI (D) Appointments to Boards: PD Citizens Advisory Council • AGENDA 10-18-94
Item VI D
• City of Ocoee
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s �0 150 N. Lakeshore Drive Jean Grafton.
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op o•• Ocoee, Florida 34761-2258 City Clerk
(407)656-2322
FAX(407)656-5725
MEMORANDUM
To: The Honorable Mayor and Board of City Commissioners
From: Jean Grafton, City Clerk
Date: October 14, 1994
Re: PD Citizens Advisory Council Appointment
This item was continued from the October 4, 1994 meeting to give Commissioner Gleason an
opportunity to speak with the applicant about being a registered voter.
Today an additional application was submitted which is included for your consideration.
"PRIDE OF WEST ORANGE"
"CENTER OF GOOD LIVING-PRIDE OF WEST ORANGE" MAYOR*COMMISSIONE 1
O� Ocoee GIVE .Corr VANDERGRIFI',, yCiiANI-)- ; /0./4.9+ COMMISSIONERS
w ►�� a CITY OF 000EF RUSTY JOHNSON
0 150 N.LAIESHORE DRIVE PAUL W.FOSTER
�, OCOEE FLORIDA 34761-2258 VERN COMBS
?c3 (407)656.2322
�'yj. �`. JIM GLEASON
OF �000 APPLICATION FOR SERVING ON CITY BOARDS CITY MA/YAGE
�y M r ^� ELLIS SHAPIRO
1. Name: $A I'igO:f/d/D/Y Home Phone: (Q 56- 3 �'S-
2. Home Address: '91 CAf O ,9 Z/tl
3. Business: Business Phone:
4. Business Address:
5. Brief Summary of Education and Experience:
6. Are you a registered voter? Yes No Precinct #
7. Resident of the City for 6 months or longer? Yes �
f� Y
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3. Do you hold public office? Yes No
9. Are you employed by the City? YesNo V-
10. Do you now serve on a City Board or Committee? Yes No
11. PLEASE CHECK THE BOARDS WHICH INTEREST YOU :
Indicate your degree of interest as first choice - 41. second choice -42. etc.
*Board of Adjustmentnn 1l *Code Enforcement
_�C.I I Board
r *Planning & Zoning Recreation Advisory j
Commission Board
ICitizen Advisory *Police Officers' and
Council for Police Firefighters' Retirement
1 Department Trust Fund Board of
i Trustees
*General Employees'
Retirement Trust Fund Personnel Board
Board of Trustees
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12. Why do y u think you are qualified to serve onthis board?
4_49
13. Would you consider serving on another Board other than one(s) you selected
above? Yes t/ No
14. Until such time you are selected for the Board of your choice, may we submit your
application when vacancies occur rather than phoning you? Yes No
15. Please attach re e'.
SIGNATURE `2� '0474 • DATE:/06/,',Z---
Note: (1) Application effective for ONE YEAR from dat f completion.
(2) If you have any questions,please call the City Clerks office at 656-2322,
extension 146.
* FINANCIAL DISCLOSURE FORMS ARE REQUIRED FOLLOWING APPOINTMENT