Garfield Reid- AP 2012-08-27V4
RECEIVED
AUG 2 9 ;
This information is a public record. F(!r0%t61TA6
Public Service opportunities are offered by the City Of Coppell without regard CIS y OF. r
to race, color, national origin, religion, sex or disability, Date R0 .PQPPELL
If you are interested in applying for more than one position (maximum of three), please indicate the order of your preference by
placing a number in the space to the left of the board/commission/committee for which you are applying (#I being your Ist
choice, #3 being your last choice) Note: Youth Advisors are not eligible for other Boards. If a board has more than 25 applicants,
interviews will only be granted to those who have chosen that particular board as their first choice. Please note that choosing
more than one board increases the chances of being appointed.
BOARD OF ADJUSTMENT PLANNING AND ZONING COMMISSION
COPPELL ECONOMIC DEV COMMITTEE
KEEP COPPELL BEAUTIFUL BOARD YOUTH ADVISOR -KEEP COPPELL BEAUTIFUL
LIBRARY BOARD YOUTH ADVISOR -LIBRARY BOARD
PARK AND RECREATION BOARD YOUTH ADVISOR -PARK & REC BOARD
W Awi"-/ SrevitYs b04Ad
If asked to serve on a different board than you indicated, would you tierimmsted? (Circle one) Y N
Would you be interested in serving on any AD Hoc Committees or Citizen Summits that may arise during the year? (Circle one) Y N
Would you be interested in serving on any non-profit organization/committee/ task force that may arise during the year? (Circle one) Y N
PLEASE TYPE OR PRINT THE FOLLOWING INFORMA TION CLEARL YIN BLACK INK ONL V.
❑ Ms.
❑ Mrs. Dr. Garfield
❑✓ Mr. Last Name
318 Hearthstone Lane, Coppell, TX 75019
Reid
First Name
A
ml
972 1462-1876
Home Address Zip Code Home Phone
4444 Trinity Mills Rd, Dallas, TX 75287 ( 972 267-3800
Business Address
Zip Code Business Phone
Resident of City for 29 years Qualified Voter?❑✓ YES❑NO (MUST BE REGISTERED TO VOTE IN THE CITY OF COPPELL)
If applying for Youth Advisor indicate grade for 2012-2013
Email Address (required if available) Txdermvet@yahoo.com
List any experience that qualifies you to serve in the positions sought. Practicing veterinarian in Small animal
practice for 9 years and veterinary specialist for 22 years working with area veterinarians.
Have you ever served as a member of any Coppell boards/commissions/committees? Yes R1 No ❑
If yes, specify which one and the approximate dates of service. Animal Services appeal board from 1994 to present.
List any civic or community activities in which you have been involved. Assistant leader soy scout Troup 874 in
Carollton Texas.
(continued on back)
Do you have any business or personal relationship with the City of Coppell that ❑ YES
would affect your ability to have impartial judgment in City matters? ❑✓ No
If yes, please explain
List your educational background. B.S. Biomedical Science 1978, Texas A&M, B.S. Veterinary Science 1980,
Texas A&M, DVM Veterinary Medicine 1981, Texas A&M College of Veterinary Medicine, Dermatology residency
1990-1992, Diplomate (board certified) American College of Veterinary Dermatology 1994.
What is your current place of employment or business affiliation? (Please indicate if you are self-
employed or not employed.) Self employed. Animal Dermatology Referral Clinic, Dallas, TX. with second office in Grapevine TX.
What is your occupational experience? Veterinarian in small animal practice in Dallas from 1981-1990,
Dermatology Referrral Practice from 1990 -present in Dallas and Grapevine Texas.
This application is the only information considered for appointments by the City Council.
Please do not send resumes, business cards, photographs or letters of recommendation.
Please call (972)304-7016 for more information about the City's boards, commissions and committees.
NOTE: APPLICATION MUST BE SIGNED 13ELOW BY APPLICANT.
STATEMENT OF INTENT: "If appointed, I agree to serve on the Board/Commission for which I have applied.
I do solemnly swear (or affirm), that I have not directly or indirectly paid, offered, promised to pay, contributed, or
promised to contribute any money or thing of value, or promised any public office or employment as a reward to secure
my appointment or confirmation, so help me God." /
8/27/12
Date: Signature:
Return to: Boards & Commissions, % City Secretary - P. O. ox 9478, Coppell, TX 75019
Or in person: City Secretary's Office - 255 Parkway Blvd., Coppell, TX 75019
(DEADLINE FOR RETURNING APPLICATION IS SEPTEMBER 21, 2012 at 5:00 p.m.)
FAX COPIES WILL NOT BE ACCEPTED!
The interview schedule is as follows and will be conducted in the evenings There will be no makeup times. If
you will not be available for
the interview, you may wish to consider another board Incumbents are required to re -interview. You will receive a letter prior to the
interview scheduling your interview time for the appropriate
date.
Park & Rec. Youth Ad.
- Mon., Oct. I
Keep Coppell Beautiful
- Thurs., Oct. 11
Library Board
- Tues., Oct. 2
Board of Adjustment
- Tues, Oct. 16
Planning & Zoning
- Wed., Oct. 3
Economic Development
- Wed., Oct. 17
Library Board Youth Ad.
- Thurs., Oct. 4
KCB Youth Ad.
- Thurs., Oct. 18
Park & Recreation Board
- Wed., Oct. 10